COVID-19 感染患者入住重症监护病房的促成因素-德国全国住院患者样本的结果。
Predisposing factors for admission to intensive care units of patients with COVID-19 infection-Results of the German nationwide inpatient sample.
机构信息
Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
出版信息
Front Public Health. 2023 Feb 15;11:1113793. doi: 10.3389/fpubh.2023.1113793. eCollection 2023.
BACKGROUND
Intensive care units (ICU) capacities are one of the most critical determinants in health-care management of the COVID-19 pandemic. Therefore, we aimed to analyze the ICU-admission and case-fatality rate as well as characteristics and outcomes of patient admitted to ICU in order to identify predictors and associated conditions for worsening and case-fatality in this critical ill patient-group.
METHODS
We used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany between January and December 2020. All hospitalized patients with confirmed COVID-19 infection during the year 2020 were included in the present study and were stratified according ICU-admission.
RESULTS
Overall, 176,137 hospitalizations of patients with COVID-19-infection (52.3% males; 53.6% aged ≥70 years) were reported in Germany during 2020. Among them, 27,053 (15.4%) were treated in ICU. COVID-19-patients treated on ICU were younger [70.0 (interquartile range (IQR) 59.0-79.0) vs. 72.0 (IQR 55.0-82.0) years, < 0.001], more often males (66.3 vs. 48.8%, < 0.001), had more frequently cardiovascular diseases (CVD) and cardiovascular risk-factors with increased in-hospital case-fatality (38.4 vs. 14.2%, < 0.001). ICU-admission was independently associated with in-hospital death [OR 5.49 (95% CI 5.30-5.68), < 0.001]. Male sex [OR 1.96 (95% CI 1.90-2.01), < 0.001], obesity [OR 2.20 (95% CI 2.10-2.31), < 0.001], diabetes mellitus [OR 1.48 (95% CI 1.44-1.53), < 0.001], atrial fibrillation/flutter [OR 1.57 (95% CI 1.51-1.62), < 0.001], and heart failure [OR 1.72 (95% CI 1.66-1.78), < 0.001] were independently associated with ICU-admission.
CONCLUSION
During 2020, 15.4% of the hospitalized COVID-19-patients were treated on ICUs with high case-fatality. Male sex, CVD and cardiovascular risk-factors were independent risk-factors for ICU admission.
背景
重症监护病房（ICU）的容量是 COVID-19 大流行期间医疗保健管理的最重要决定因素之一。因此，我们旨在分析 ICU 入院和病死率，以及 ICU 入院患者的特征和结局，以确定该重症患者群体中病情恶化和病死率的预测因素和相关情况。
方法
我们使用德国全国住院患者样本分析了 2020 年 1 月至 12 月期间德国所有确诊 COVID-19 诊断的住院患者。本研究纳入了 2020 年所有确诊 COVID-19 感染的住院患者，并根据 ICU 入院进行分层。
结果
总体而言，2020 年德国报告了 176137 例 COVID-19 感染住院患者（52.3%为男性；53.6%年龄≥70 岁）。其中，27053 例（15.4%）在 ICU 接受治疗。在 ICU 接受治疗的 COVID-19 患者更年轻[70.0（四分位距（IQR）59.0-79.0）vs. 72.0（IQR 55.0-82.0）岁，<0.001]，更多为男性（66.3% vs. 48.8%，<0.001），更常患有心血管疾病（CVD）和心血管危险因素，院内病死率更高（38.4% vs. 14.2%，<0.001）。ICU 入院与院内死亡独立相关[比值比（OR）5.49（95%CI 5.30-5.68），<0.001]。男性[OR 1.96（95%CI 1.90-2.01），<0.001]、肥胖[OR 2.20（95%CI 2.10-2.31），<0.001]、糖尿病[OR 1.48（95%CI 1.44-1.53），<0.001]、心房颤动/扑动[OR 1.57（95%CI 1.51-1.62），<0.001]和心力衰竭[OR 1.72（95%CI 1.66-1.78），<0.001]与 ICU 入院独立相关。
结论
2020 年，15.4%的 COVID-19 住院患者在 ICU 接受治疗，病死率较高。男性、CVD 和心血管危险因素是 ICU 入院的独立危险因素。
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