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2019冠状病毒病患者的发病和死亡模式及其相关危险因素:一项横断面研究。

Morbidity and mortality pattern of COVID-19 patients and its associated risk factors: A cross-sectional study.

作者信息

Keisam Avinash, Kulabidhu Heisnam, Singh Takhellambam B, Devi Laishram B, Akham Ngamba

机构信息

Department of Community Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.

Department of Orthodontics and Dentofacial Orthopedics, Regional Institute of Medical Sciences, Imphal, Manipur, India.

出版信息

J Family Med Prim Care. 2022 Sep;11(9):5643-5648. doi: 10.4103/jfmpc.jfmpc_997_22. Epub 2022 Oct 14.

Abstract

BACKGROUND

Early identification of patients with poor prognosis may facilitate the provision of proper supportive treatment in advance and reduce mortality due to Coronavirus Disease 2019 (COVID-19). The present study estimates the recovery and mortality rates among in-house COVID-19 patients admitted to a tertiary care center and also determines any association between mortality and variables of interest.

METHODS AND MATERIAL

This cross-sectional study was conducted in June to December 2021 among the COVID-19 patients admitted to the hospital based on their case sheets. A sample size of 1500 was calculated which was obtained by simple random sampling. Descriptive statistics were generated. Association between mortality and other variables was tested by using bivariate logistic regression and multiple logistic regression analysis.

RESULTS

The overall recovery rate was 80.1%. Vaccination status was significantly associated with mortality, with the AOR (95% CI) of getting both vaccine doses and a single dose being 0.18 (0.05-0.70) and 0.28 (0.15-0.55), respectively, when compared to the unvaccinated group. Also, patients who sought admission on their own were found to be having more chances of recovery compared to those who were referred from other health facilities. The risk of dying was found to be increased nearly 5-fold among those who used Non-Rebreathing machines. The use of Non-Invasive ventilation and Bain Circuit was significantly associated with a bad prognosis. None on the mechanical ventilation survived.

CONCLUSIONS

The mortality rate of COVID-19 patients admitted to the tertiary care hospital was found to be one-fifth and the ICU-specific mortality rate was 83.6% while other factors like age and gender were not found to be associated with mortality. Among comorbidities, only liver diseases were found to be a significant determinant of mortality. Finally, patients who needed more flow rate of oxygen had a significant association with mortality.

摘要

背景

早期识别预后不良的患者可能有助于提前提供适当的支持性治疗,并降低2019冠状病毒病(COVID-19)导致的死亡率。本研究估计了一家三级医疗中心收治的住院COVID-19患者的康复率和死亡率,并确定死亡率与相关变量之间的任何关联。

方法和材料

本横断面研究于2021年6月至12月对收治入院的COVID-19患者根据其病历进行。计算出样本量为1500,通过简单随机抽样获得。生成描述性统计数据。使用双变量逻辑回归和多变量逻辑回归分析检验死亡率与其他变量之间的关联。

结果

总体康复率为80.1%。疫苗接种状况与死亡率显著相关,与未接种疫苗组相比,接种两剂疫苗和接种一剂疫苗的调整后比值比(95%置信区间)分别为0.18(0.05 - 0.70)和0.28(0.15 - 0.55)。此外,自行入院的患者与从其他医疗机构转诊而来的患者相比,康复机会更多。使用非重复呼吸面罩的患者死亡风险增加近5倍。使用无创通气和贝恩回路与预后不良显著相关。接受机械通气的患者无一存活。

结论

发现三级医疗医院收治的COVID-19患者死亡率为五分之一,重症监护病房(ICU)特定死亡率为83.6%,而年龄和性别等其他因素与死亡率无关。在合并症中,仅肝脏疾病被发现是死亡率的重要决定因素。最后,需要更高氧流量的患者与死亡率显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac32/9730952/a0556d5bb157/JFMPC-11-5643-g001.jpg

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