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COVID-19相关院内死亡的临床和实验室预测因素;一项对1000例病例的横断面研究。

Clinical and Laboratory Predictors of COVID-19-Related In-hospital Mortality; a Cross-sectional Study of 1000 Cases.

作者信息

Mohammadi Zohreh, Faghih Dinevari Masood, Vahed Nafiseh, Ebrahimi Bakhtavar Haniyeh, Rahmani Farzad

机构信息

Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Email:

出版信息

Arch Acad Emerg Med. 2022 Jun 23;10(1):e49. doi: 10.22037/aaem.v10i1.1574. eCollection 2022.

Abstract

INTRODUCTION

Identifying patients at risk for mortality and using appropriate treatment for each patient based on their situation could be an effective strategy in improving their outcome. This study aimed to evaluated the predictors of COVID-19 in-hospital mortality.

METHODS

This descriptive cross-sectional study was conducted on all adult COVID-19 patients who were managed in Imam-Reza and Sina Hospitals, Tabriz, Iran, from November 2020 until December 2021. The demographic, clinical, and laboratory characteristics of patients were evaluated and predictors of in-hospital mortality were identified using logistic regression model.

RESULTS

1000 patients with the mean age of 56.34 ± 18.00 years were studied (65.7% male). There were significant associations between COVID-19 in-hospital mortality and hospitalization above five days (p = 0.001), white blood cell count (WBC) > 4000 Cells*103/mL (p < 0.01), aspartate aminotransferase (AST) above 40 IU/L (p = 0.001), alanine transaminase (ALT) above 40 IU/L (p = 0.001), creatinine above 1.4 mg/dL (p = 0.007), urea above 100 mg/dL (p = 0.024), and SaO2 below 80% (p = 0.001). Hospital stay above five days (OR: 3.473; 95%CI: 1.272 - 9.479; p = 0.15), AST above 40 IU/L (OR: 0.269, 95%CI: 0.179 - 0.402; p = 0.001), creatinine above 1.4 mg/dL (OR: 0.529; 95%CI: 0.344 - 0.813; p = 0.004), urea above 100 mg/dL (OR: 0.327, 95%CI: 0.189 - 0.567; p = 0.001), and SaO2 below 80% (OR: 8.754, 95%CI: 5.413 - 14.156; p = 0.001) were among the independent predictors of COVID-19 in-hospital mortality.

CONCLUSION

The mortality rate of patients with COVID-19 in our study was 29.9%. Hospitalization of more than five days, AST above 40 IU/L, creatinine above 1.4 mg/dL, urea above 100 mg/dL and SaO2 < 80% were independent risk factors of in-hospital mortality among patients with COVID-19.

摘要

引言

识别有死亡风险的患者,并根据每位患者的情况采取适当的治疗措施,可能是改善其预后的有效策略。本研究旨在评估新冠病毒病(COVID-19)住院死亡率的预测因素。

方法

本描述性横断面研究对2020年11月至2021年12月期间在伊朗大不里士的伊玛目·礼萨医院和西纳医院接受治疗的所有成年COVID-19患者进行。评估患者的人口统计学、临床和实验室特征,并使用逻辑回归模型确定住院死亡率的预测因素。

结果

共研究了1000例患者,平均年龄为56.34±18.00岁(男性占65.7%)。COVID-19住院死亡率与住院超过五天(p = 0.001)、白细胞计数(WBC)>4000个细胞*10³/mL(p < 0.01)、天冬氨酸转氨酶(AST)高于40 IU/L(p = 0.001)、丙氨酸转氨酶(ALT)高于40 IU/L(p = 0.001)、肌酐高于1.4 mg/dL(p = 0.007)、尿素高于100 mg/dL(p = 0.024)以及血氧饱和度(SaO₂)低于80%(p = 0.001)之间存在显著关联。住院超过五天(比值比:3.473;95%置信区间:1.272 - 9.479;p = 0.15)、AST高于40 IU/L(比值比:0.269,95%置信区间:0.179 - 0.402;p = 0.001)、肌酐高于1.4 mg/dL(比值比:0.529;95%置信区间:0.344 - 0.813;p = 0.004)、尿素高于100 mg/dL(比值比:0.327,95%置信区间:0.189 - 0.567;p = 0.001)以及SaO₂低于80%(比值比:8.754,95%置信区间:5.413 - 14.156;p = 0.001)是COVID-19住院死亡率的独立预测因素。

结论

我们研究中COVID-19患者的死亡率为29.9%。住院超过五天、AST高于40 IU/L、肌酐高于1.4 mg/dL、尿素高于100 mg/dL以及SaO₂<80%是COVID-19患者住院死亡率的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f44b/9397590/cfbc8124f882/aaem-10-e49-g001.jpg

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