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与 COVID-19 老年患者 ICU 入院风险相关的合并症:来自沙特阿拉伯学术医院的数据。

Comorbidities associated with risk of ICU admission in elderly patients with COVID-19: Data from academic hospital in Saudi Arabia.

机构信息

Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Medicine (Baltimore). 2022 Sep 30;101(39):e30799. doi: 10.1097/MD.0000000000030799.

Abstract

The coronavirus disease 2019 (COVID-19) has affected millions of people worldwide, of which 5% required intensive care, especially mechanical ventilation. The prognosis depends on several factors including comorbidities. This study was conducted to identify the comorbidities associated with the intensive care unit (ICU) admission in elderly with COVID-19 admitted to a tertiary academic hospital. A retrospective cross-sectional study was conducted at KSUMC including all hospitalized patients (age ≥ 65 years) with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection admitted between March 2020 and August 2021. Data collection included sociodemographic characteristics, underlying comorbidities, and the Charlson comorbidity index. Comorbidities were compared between the elderly patients with COVID-19 admitted to the ICU and those not admitted to the ICU. The odds ratios were calculated and a P value of < .05 and 95% confidence intervals were used to report the statistical significance A total of 444 patients (ICU = 147, non-ICU = 297) were included in the study. The study revealed that elderly patients with COVID-19 admitted to ICU had a higher rate of mortality (n = 64, 67.4%; P < .0001) and a higher proportion of them had shortness of breath (n = 97, 38.3%; P = .007) compared to the elderly patients not admitted to ICU. The mean length of stay (P < .0001), and weight (P = .02) among ICU patients were higher than the values for the non-ICU group, while the mean oxygen saturation (SpO2; P = .006) was lower among the ICU group. The comorbidities that demonstrated a statistically significant association with ICU admission were heart failure (P = .004, odd ratio (OR) = 2.02, 95% confidence intervals (CI) [1.263, 3540]), chronic obstructive pulmonary disease (COPD; P = .027, OR = 3.361, 95% CI [1.080, 10.464]), and chronic kidney disease (P = .021, OR = 1.807, 95% CI [1.087, 3.006]). The current study identified that the comorbidities such as COPD, heart failure, and factors like SpO2 and length of stay are associated with an increased risk of ICU admission in elderly patients with COVID-19. These findings highlight the clinical implications of comorbidity among geriatric population.

摘要

2019 年冠状病毒病(COVID-19)已影响到全球数百万人,其中 5%需要重症监护,尤其是机械通气。预后取决于包括合并症在内的几个因素。本研究旨在确定与在三级学术医院住院的老年 COVID-19 患者入住重症监护病房(ICU)相关的合并症。在 KSUMC 进行了一项回顾性横断面研究,包括 2020 年 3 月至 2021 年 8 月期间实验室确诊的严重急性呼吸综合征冠状病毒 2 感染住院的所有(年龄≥65 岁)患者。数据收集包括社会人口统计学特征、基础合并症和 Charlson 合并症指数。比较了入住 ICU 和未入住 ICU 的老年 COVID-19 患者的合并症。计算了比值比,并报告了 P 值<.05 和 95%置信区间,以报告统计学意义。共有 444 名患者(ICU=147,非 ICU=297)纳入研究。研究表明,入住 ICU 的老年 COVID-19 患者死亡率较高(n=64,67.4%;P<.0001),呼吸困难比例较高(n=97,38.3%;P=.007)与未入住 ICU 的老年患者相比。ICU 患者的平均住院时间(P<.0001)和体重(P=.02)高于非 ICU 组,而 ICU 组的平均血氧饱和度(SpO2;P=.006)较低。与 ICU 入院有统计学显著关联的合并症有心衰(P=.004,比值比(OR)=2.02,95%置信区间(CI)[1.263,3540])、慢性阻塞性肺疾病(COPD;P=.027,OR=3.361,95% CI [1.080,10.464])和慢性肾脏病(P=.021,OR=1.807,95% CI [1.087,3.006])。目前的研究表明,COPD、心力衰竭等合并症以及 SpO2 和住院时间等因素与老年 COVID-19 患者 ICU 入院风险增加相关。这些发现强调了老年人群中合并症的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a949/9524982/c811118526b2/medi-101-e30799-g001.jpg

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