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高海拔地区因 COVID-19 住院的成年人入住重症监护病房或死亡的危险因素。

Risk factors for intensive care unit admission or mortality in adults hospitalized for COVID-19 at high altitude.

机构信息

Programa de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú.

Hospital Regional Manuel Núñez Butron, Puno, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2022 Apr-Jun;39(2):143-151. doi: 10.17843/rpmesp.2022.392.10721. Epub 2022 Sep 2.

Abstract

OBJECTIVE.: To determine the risk factors for admission to the intensive care unit (ICU) or mortality in patients hospitalized for COVID-19 in a hospital in Puno, Peru.

MATERIALS AND METHODS.: Retrospective cohort study in adults hospitalized between April and December 2020. We evaluated Sociodemographic characteristics, vital functions, comorbidities, treatment received and its association with admission to ICU or mortality (adverse outcome). Poisson regression with robust variance was used to calculate crude and adjusted relative risks (RR) with their 95% confidence intervals (95%CI).

RESULTS.: A total of 348 medical records were analyzed. The median age in years was 42.5 (IQR: 30.0; 58.0); 38.2% were male, and 35.3% died or were admitted to the ICU. Those admitted with an oxygen saturation ≤ 75% were 2.79 times more likely to have the adverse outcome (p < 0.001), compared to those admitted with a saturation ≥ 85%; those admitted with a value between 75-79% were 2.92 times more likely to have the adverse outcome (p < 0.001); likewise, those admitted with saturation between 80-84% were 1.70 times more likely to have the adverse outcome; however, the difference was not statistically significant (p=0.066). In addition, male patients, RR= 1.75 (p<0.001); those aged > 40 years, RR 3.5 (p=0.001); those with tachypnea, RR=1.66 (p=0.010); or with diabetes, RR = 1.53 (p=0.011) had higher risk of presenting the adverse outcome.

CONCLUSIONS.: The risk factors for ICU admission or mortality due to COVID-19 were male sex, age over 40 years, low saturation, diabetes and tachypnea.

摘要

目的

确定秘鲁普诺一家医院因 COVID-19 住院的患者入住重症监护病房(ICU)或死亡的危险因素。

材料和方法

这是一项回顾性队列研究,纳入 2020 年 4 月至 12 月期间住院的成年人。我们评估了社会人口统计学特征、生命体征、合并症、接受的治疗及其与入住 ICU 或死亡(不良结局)的关系。采用稳健方差的泊松回归计算粗相对风险(RR)和调整 RR 及其 95%置信区间(95%CI)。

结果

共分析了 348 份病历。年龄中位数为 42.5(IQR:30.0;58.0);38.2%为男性,35.3%死亡或入住 ICU。与血氧饱和度≥85%的患者相比,血氧饱和度≤75%的患者发生不良结局的风险高 2.79 倍(p<0.001);血氧饱和度在 75-79%的患者发生不良结局的风险高 2.92 倍(p<0.001);同样,血氧饱和度在 80-84%之间的患者发生不良结局的风险高 1.70 倍;然而,差异无统计学意义(p=0.066)。此外,男性患者(RR=1.75,p<0.001)、年龄>40 岁(RR=3.5,p=0.001)、呼吸急促(RR=1.66,p=0.010)或患有糖尿病(RR=1.53,p=0.011)的患者发生不良结局的风险更高。

结论

COVID-19 患者入住 ICU 或死亡的危险因素为男性、年龄>40 岁、低血氧饱和度、糖尿病和呼吸急促。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8891/11397585/9dc860fe8151/rpmesp-39-02-10721-g001.jpg

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