印度古吉拉特邦一家三级护理医院第二波 COVID-19 患者住院期间死亡率的相关预测因素：一项回顾性观察研究。
Predictors Associated with In-hospital Mortality among COVID-19 Patients during the Second Wave in a Tertiary Care Hospital, Gujarat, India: A Retrospective Observational Study.
机构信息
Assistant Professor, Department of Community Medicine.
Associate Professor, Department of Medicine.
出版信息
J Assoc Physicians India. 2022 Nov;70(11):11-12. doi: 10.5005/japi-11001-0127.
BACKGROUND
Fatalities due to coronavirus disease 2019 (COVID-19) have already crossed to more than 5 million globally so far. Hence, it is crucial for us to identify the risk factors associated with hospital deaths starting from first contact which can help to give timely treatment to the targeted population.
OBJECTIVES
This retrospective cohort study was conducted to identify various factors related to in-hospital mortality related to COVID-19 in our region.
MATERIALS AND METHODS
The present study was a single-center, retrospective cohort study of 675 adult patients, admitted with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between 1st April and 25th May 2021 in our tertiary care hospital. Baseline demographic profile, comorbidities, clinical characteristics, and investigatory findings were analyzed for increased odds of mortality.
RESULTS
A total of 181 (26.8%) patients died and 494 (73.2%) survived. There were 65.4% of males and no difference was found between genders in terms of mortality. Comorbidities associated with in-hospital death in our cohort were age group ≥50 years (p<0.001), diabetes (p<0.0007), and renal injury (p<0.0001). More than half of the patients died during the first week of admission. Breathlessness (83%) was the most common symptom in non-survivors. Neutrophil-to-lymphocyte ratio (NLR), S. creatinine, D-dimer, ferritin, and C-reactive protein (CRP) were increased significantly among the patients who died. Multivariate logistic regression revealed age ≥50 years [adjusted odds ratio (AOR) 2.30, 95% confidence interval (CI) 1.45-3.64] and oxygen (O2) saturation <94% at the time of admission (AOR 2.62, 95% CI 1.75-3.93) were associated with mortality.
CONCLUSION
Overall in-hospital mortality was 26.8%. Higher age and low O2 saturation were the major risk factors associated with in-hospital mortality.
背景
截至目前，全球因 2019 年冠状病毒病（COVID-19）导致的死亡人数已超过 500 万。因此，从首次接触开始，确定与医院死亡相关的风险因素至关重要，这有助于为目标人群提供及时的治疗。
目的
本回顾性队列研究旨在确定与 COVID-19 相关的住院死亡率相关的各种因素。
材料和方法
本研究为单中心、回顾性队列研究，纳入了 2021 年 4 月 1 日至 5 月 25 日期间在我们的三级保健医院因确诊严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染而住院的 675 例成年患者。分析了基线人口统计学特征、合并症、临床特征和检查结果，以确定死亡率增加的可能性。
结果
共有 181 例（26.8%）患者死亡，494 例（73.2%）存活。男性占 65.4%，但在性别方面，死亡率没有差异。本队列中与院内死亡相关的合并症为年龄≥50 岁（p<0.001）、糖尿病（p<0.0007）和肾损伤（p<0.0001）。超过一半的患者在入院后的第一周内死亡。在非幸存者中，最常见的症状是呼吸困难（83%）。死亡患者的中性粒细胞与淋巴细胞比值（NLR）、S. 肌酐、D-二聚体、铁蛋白和 C 反应蛋白（CRP）显著升高。多变量逻辑回归显示，年龄≥50 岁[调整后的优势比（AOR）2.30，95%置信区间（CI）1.45-3.64]和入院时血氧饱和度<94%（AOR 2.62，95%CI 1.75-3.93）与死亡率相关。
结论
总体住院死亡率为 26.8%。较高的年龄和较低的 O2 饱和度是与住院死亡率相关的主要危险因素。
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