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Barthel 指数对 COVID-19 患者死亡率的预后价值:一项横断面研究。

The prognostic value of the Barthel Index for mortality in patients with COVID-19: A cross-sectional study.

机构信息

Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Division of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Public Health. 2023 Jan 24;10:978237. doi: 10.3389/fpubh.2022.978237. eCollection 2022.

Abstract

OBJECTIVE

This study aimed to analyze the association between the activity of daily living (ADL), coronavirus disease (COVID-19), and the value of the Barthel Index in predicting the prognosis of patients.

METHODS

This study included 398 patients with COVID-19, whose ADL at admission to hospital were assessed with the Barthel Index. The relationship between the index and the mortality risk of the patients was analyzed. Several regression models and a decision tree were established to evaluate the prognostic value of the index in COVID-19 patients.

RESULTS

The Barthel Index scores of deceased patients were significantly lower than that of discharged patients (median: 65 vs. 90, < 0.001), and its decrease indicated an increased risk of mortality in patients ( < 0.001). After adjusting models for age, gender, temperature, pulse, respiratory rate, mean arterial pressure, oxygen saturation, etc., the Barthel Index could still independently predict prognosis (OR = 0.809; 95% CI: 0.750-0.872). The decision tree showed that patients with a Barthel Index of below 70 had a higher mortality rate (33.3-40.0%), while those above 90 were usually discharged (mortality: 2.7-7.2%).

CONCLUSION

The Barthel Index is of prognostic value for mortality in COVID-19 patients. According to their Barthel Index, COVID-19 patients can be divided into emergency, observation, and normal groups (0-70; 70-90; 90-100), with different treatment strategies.

摘要

目的

本研究旨在分析日常生活活动(ADL)、冠状病毒病(COVID-19)与巴氏指数(Barthel Index)值之间的关系,以预测患者的预后。

方法

本研究纳入了 398 例 COVID-19 患者,入院时采用巴氏指数评估其日常生活活动能力。分析该指数与患者死亡风险的关系。建立了几种回归模型和决策树,以评估该指数在 COVID-19 患者中的预后价值。

结果

死亡患者的巴氏指数评分明显低于出院患者(中位数:65 分比 90 分, < 0.001),且其下降表明患者死亡风险增加( < 0.001)。在调整年龄、性别、体温、脉搏、呼吸频率、平均动脉压、血氧饱和度等因素的模型后,巴氏指数仍能独立预测预后(OR=0.809;95%CI:0.750-0.872)。决策树显示,巴氏指数<70 的患者死亡率较高(33.3%-40.0%),而巴氏指数>90 的患者通常出院(死亡率:2.7%-7.2%)。

结论

巴氏指数对 COVID-19 患者的死亡率具有预后价值。根据巴氏指数,COVID-19 患者可分为紧急、观察和正常组(0-70;70-90;90-100),采取不同的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/9902915/2f94a6816569/fpubh-10-978237-g0001.jpg

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