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墨西哥一家私立三级护理中心的一项为期两年的队列研究:住院成人 COVID-19 肺炎患者死亡的危险因素。

Risk Factors for Mortality of Hospitalized Adult Patients with COVID-19 Pneumonia: A Two-Year Cohort Study in a Private Tertiary Care Center in Mexico.

机构信息

Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Zapopan 45201, Mexico.

Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico.

出版信息

Int J Environ Res Public Health. 2023 Mar 2;20(5):4450. doi: 10.3390/ijerph20054450.

Abstract

During the COVID-19 pandemic, the high prevalence of comorbidities and the disparities between the public and private health subsystems in Mexico substantially contributed to the severe impact of the disease. The objective of this study was to evaluate and compare the risk factors at admission for in-hospital mortality of patients with COVID-19. A 2-year retrospective cohort study of hospitalized adult patients with COVID-19 pneumonia was conducted at a private tertiary care center. The study population consisted of 1258 patients with a median age of 56 ± 16.5 years, of whom 1093 recovered (86.8%) and 165 died (13.1%). In the univariate analysis, older age ( < 0.001), comorbidities such as hypertension ( < 0.001) and diabetes ( < 0.001), signs and symptoms of respiratory distress, and markers of acute inflammatory response were significantly more frequent in non-survivors. The multivariate analysis showed that older age ( < 0.001), the presence of cyanosis ( = 0.005), and previous myocardial infarction ( = 0.032) were independent predictors of mortality. In the studied cohort, the risk factors present at admission associated with increased mortality were older age, cyanosis, and a previous myocardial infarction, which can be used as valuable predictors for patients' outcomes. To our knowledge, this is the first study analyzing predictors of mortality in COVID-19 patients attended in a private tertiary hospital in Mexico.

摘要

在 COVID-19 大流行期间,合并症的高发率以及墨西哥公共和私营卫生系统之间的差异,极大地加剧了该疾病的严重影响。本研究旨在评估和比较 COVID-19 患者住院期间因院内死亡的入院风险因素。对一家私立三级保健中心收治的成年 COVID-19 肺炎住院患者进行了为期 2 年的回顾性队列研究。研究人群包括 1258 名中位年龄为 56 ± 16.5 岁的患者,其中 1093 例康复(86.8%),165 例死亡(13.1%)。在单因素分析中,年龄较大(<0.001)、合并症(如高血压(<0.001)和糖尿病(<0.001))、呼吸窘迫的迹象和症状以及急性炎症反应标志物在非幸存者中更为常见。多因素分析显示,年龄较大(<0.001)、发绀(=0.005)和先前心肌梗死(=0.032)是死亡的独立预测因素。在研究队列中,与死亡率增加相关的入院时存在的危险因素是年龄较大、发绀和先前的心肌梗死,这些因素可作为患者预后的有价值的预测指标。据我们所知,这是首次分析在墨西哥一家私立三级医院接受治疗的 COVID-19 患者的死亡预测因素的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/891d/10001871/e05684849abd/ijerph-20-04450-g001.jpg

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