Mastaneh Zahra, Mouseli Ali, Mohseni Shokrollah, Dadipoor Sara
Department of Health Information Management and Technology, School of Allied Medical Sciences, Infectious and Tropical Diseases Research Center Hormozgan University of Medical Sciences Bandar Abbas Iran.
Department of Public Health, School of Health, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute Hormozgan University of Medical Sciences Bandar Abbas Iran.
Health Sci Rep. 2023 Jun 14;6(6):e1329. doi: 10.1002/hsr2.1329. eCollection 2023 Jun.
About one-fifth of patients with COVID-19 need to be hospitalized. Predicting factors affecting the hospital length of stay (LOS) can be effective in prioritizing patients, planning for services, and preventing the increase in LOS and death of patients. The present study aimed to identify the factors that predict LOS and mortality in COVID-19 patients in a retrospective cohort study.
A total of 27,859 patients were admitted to 22 hospitals from February 20, 2020 to June 21, 2021. The data collected from 12,454 patients were screened according to the inclusion and exclusion criteria. The data were captured from the MCMC (Medical Care Monitoring Center) database. The study tracked patients until their hospital discharge or death. Hospital LOS and mortality were assessed as the study outcomes.
As the results revealed, 50.8% of patients were male and 49.2% were female. The mean hospital LOS of the discharged patients was 4.94. Yet, 9.1% of the patients ( = 1133) died. Among the predictors of mortality and long hospital LOS were the age above 60, admission to the ICU, coughs, respiratory distress, intubation, oxygen level less than 93%, cigarette and drug abuse, and a history of chronic diseases. Masculinity, gastrointestinal symptoms, and cancer were the effective variables in mortality, and positive CT was a factor significantly affecting the hospital LOS.
Paying special attention to high-risk patients and modifiable risk factors such as heart disease, liver disease, and other chronic diseases can diminish the complications and mortality rate of COVID-19. Providing training, especially for those who care for patients experiencing respiratory distress such as nurses and operating room personnel can improve the qualifications and skills of medical staff. Also, ensuring the availability of sufficient supply of medical equipment is strongly recommended.
约五分之一的新冠病毒疾病（COVID-19）患者需要住院治疗。预测影响住院时长（LOS）的因素有助于对患者进行优先排序、规划服务，并防止患者住院时长增加和死亡。本研究旨在通过一项回顾性队列研究，确定预测COVID-19患者住院时长和死亡率的因素。
2020年2月20日至2021年6月21日期间，共有27859名患者入住22家医院。根据纳入和排除标准，对从12454名患者收集的数据进行筛选。数据来自马尔代夫医疗监测中心（MCMC）数据库。该研究对患者进行跟踪，直至其出院或死亡。将住院时长和死亡率作为研究结果进行评估。
结果显示，50.8%的患者为男性，49.2%为女性。出院患者的平均住院时长为4.94天。然而，9.1%的患者（n = 1133）死亡。年龄在60岁以上、入住重症监护病房（ICU）、咳嗽、呼吸窘迫、插管、血氧水平低于93%、吸烟和药物滥用以及有慢性病病史是死亡率和住院时间延长的预测因素。男性、胃肠道症状和癌症是影响死亡率的有效变量，而CT阳性是显著影响住院时长的一个因素。
特别关注高危患者以及心脏病、肝病和其他慢性病等可改变的风险因素，可以降低COVID-19的并发症和死亡率。提供培训，特别是对护士和手术室工作人员等照顾呼吸窘迫患者的人员进行培训，可以提高医务人员的资质和技能。此外，强烈建议确保有足够的医疗设备供应。
