Department of Anesthesiology and Intensive Care Medicine, Tübingen University Hospital, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
Institute for Clinical Epidemiology and Applied Biometry, Faculty of Medicine, University of Tübingen, Tübingen, Germany.
Crit Care. 2023 Feb 5;27(1):48. doi: 10.1186/s13054-023-04330-y.
Health-related quality of life after surviving acute respiratory distress syndrome has come into focus in recent years, especially during the coronavirus disease 2019 pandemic.
A total of 144 patients with acute respiratory distress syndrome caused by COVID-19 or of other origin were recruited in a randomized multicenter trial.
Clinical data during intensive care treatment and data up to 180 days after study inclusion were collected. Changes in the Sequential Organ Failure Assessment score were used to quantify disease severity. Disability was assessed using the Barthel index on days 1, 28, 90, and 180.
Mortality rate and morbidity after 180 days were compared between patients with and without COVID-19. Independent risk factors associated with high disability were identified using a binary logistic regression.
The SOFA score at day 5 was an independent risk factor for high disability in both groups, and score dynamic within the first 5 days significantly impacted disability in the non-COVID group. Mortality after 180 days and impairment measured by the Barthel index did not differ between patients with and without COVID-19.
Resolution of organ dysfunction within the first 5 days significantly impacts long-term morbidity. Acute respiratory distress syndrome caused by COVID-19 was not associated with increased mortality or morbidity.
近年来,急性呼吸窘迫综合征(ARDS)幸存者的健康相关生活质量已成为关注焦点,尤其是在 2019 年冠状病毒病(COVID-19)大流行期间。
本项随机多中心试验共招募了 144 例由 COVID-19 或其他病因引起的 ARDS 患者。
收集了重症监护治疗期间的临床数据和纳入研究后 180 天的数据。采用序贯器官衰竭评估(SOFA)评分的变化来量化疾病严重程度。在第 1、28、90 和 180 天使用巴氏指数(Barthel index)评估残疾情况。
比较了 COVID-19 组和非 COVID-19 组患者在 180 天后的死亡率和发病率。采用二元逻辑回归分析确定与高残疾相关的独立危险因素。
两组患者第 5 天的 SOFA 评分是高残疾的独立危险因素,前 5 天的评分动态对非 COVID 组的残疾有显著影响。COVID-19 组和非 COVID-19 组患者在 180 天后的死亡率和 Barthel 指数评估的损伤无差异。
第 1 天至第 5 天内器官功能障碍的缓解显著影响长期发病率。COVID-19 引起的 ARDS 与死亡率或发病率增加无关。