姆巴拉拉地区转诊医院收治的重症新冠患者30天院内死亡率的相关因素
Factors Associated with 30-Day in-Hospital Mortality Among Patients Admitted with Severe Covid-19 in Mbarara Regional Referral Hospital.
作者信息
Mutekanga Andrew, Nuwagira Edwin, Kumbakumba Elias, Nyaiteera Victoria, Asiimwe Stephen, Gasumuni Medal, Wandera Nelson, Natumanya Robert, Akena Denis, Senoga Siraje, Kyobe Kiwanuka Joseph, Kateregga George, Munyarugero Emmanuel, Abeya Fardous Charles, Obwoya Paul Stephen, Ttendo Stephen, Muhindo Rose
机构信息
Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda.
出版信息
Infect Drug Resist. 2022 Dec 6;15:7157-7164. doi: 10.2147/IDR.S379443. eCollection 2022.
BACKGROUND
COVID-19 has created a burden on the healthcare system globally. Severe COVID-19 is linked with high hospital mortality. Data regarding 30-day in-hospital mortality and its factors has not been explored in southwestern Uganda.
METHODS
We carried out a retrospective, single-center cohort study, and included all in-patients with laboratory-confirmed, radiological, or clinical severe COVID-19 admitted between April 2020 and September 2021 at Mbarara Regional Referral Hospital (MRRH). Demographic, laboratory, treatment, and clinical outcome data were extracted from patients' files. These data were described comparing survivors and non-survivors. We used logistic regression to explore the factors associated with 30-day in-hospital mortality.
RESULTS
Of the 283 patients with severe COVID-19 admitted at MRRH COVID-19 unit, 58.1% were male. The mean age ± standard deviation (SD) was 61±17.4 years; there were no differences in mean age between survivors and non-survivors (59 ± 17.2 versus 64.4 ±17.3, respectively, p=0.24) The median length of hospital stay was 7 (IQR 3-10) days (non-survivors had a shorter median length of stay 5 (IQR 2-9) days compared to the survivors; 8 (IQR 5-11) days, p<0.001. The most frequent comorbidities were hypertension (30.5%) and diabetes mellitus (30%). The overall 30-day in-hospital mortality was 134 of 279 (48%) mortality rate of 47,350×10 with a standard error of 2.99%. The factors associated with 30-day in-hospital mortality were age: 65 years and above (aOR, 3.88; 95% CI, 1.24-11.70; P =0.020) a neutrophil to lymphocyte ratio above 5 (aOR, 4.83; 95% CI, 1.53-15.28; P =0.007) and oxygen requirement ≥15L/min (aOR, 15.80; 95% CI, 5.17-48.25; P <0.001).
CONCLUSION
We found a high 30-day in-hospital mortality among patients with severe forms of COVID-19. The identified factors could help clinicians to identify patients with poor prognosis at an early stage of admission.
背景
新型冠状病毒肺炎（COVID-19）给全球医疗系统带来了负担。重症COVID-19与高住院死亡率相关。乌干达西南部尚未对30天住院死亡率及其影响因素进行研究。
方法
我们进行了一项回顾性单中心队列研究，纳入2020年4月至2021年9月期间在姆巴拉拉地区转诊医院（MRRH）收治的所有实验室确诊、影像学或临床诊断为重症COVID-19的住院患者。从患者病历中提取人口统计学、实验室检查、治疗及临床结局数据。对这些数据进行描述，比较幸存者和非幸存者。我们使用逻辑回归分析来探讨与30天住院死亡率相关的因素。
结果
在MRRH COVID-19病房收治的283例重症COVID-19患者中，58.1%为男性。平均年龄±标准差（SD）为61±17.4岁；幸存者和非幸存者的平均年龄无差异（分别为59±17.2岁和64.4±17.3岁，p = 0.24）。住院时间中位数为7（四分位间距[IQR] 3 - 10）天（非幸存者的住院时间中位数较短，为5（IQR 2 - 9）天，而幸存者为8（IQR 5 - 11）天，p < 0.001）。最常见的合并症是高血压（30.5%）和糖尿病（30%）。279例患者中30天住院死亡率为134例（48%），死亡率为47350×10，标准误为2.99%。与30天住院死亡率相关的因素包括：年龄65岁及以上（调整后比值比[aOR]，3.88；95%置信区间[CI]，1.24 - 11.70；P = 0.020）、中性粒细胞与淋巴细胞比值高于5（aOR，4.83；95% CI，1.53 - 15.28；P = 0.007）以及吸氧需求≥15L/分钟（aOR，15.80；95% CI，5.17 - 48.
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