Deguchi Ryo, Nishimura Tetsuro, Matsuo Kenji, Wakita Fumiaki, Kawamoto Akihiro, Uchida Kenichiro, Yamamoto Hiromasa, Yamada Koichi, Kakeya Hiroshi, Fujii Hiromichi, Shibata Toshihiko, Mizobata Yasumitsu
Department of Traumatology and Critical Care Medicine Osaka Metropolitan University Graduate School of Medicine Osaka Japan.
Department of Infection Control Science Osaka Metropolitan University Graduate School of Medicine Osaka Japan.
Acute Med Surg. 2023 Jul 8;10(1):e868. doi: 10.1002/ams2.868. eCollection 2023 Jan-Dec.
Coronavirus disease (COVID-19) spread worldwide, and was declared as a pandemic by the World Health Organization. Despite numerous studies in the last few years, the factors associated with the outcomes of patients with COVID-19 requiring mechanical ventilation remain unclear. The prediction of ventilator weaning and mortality using the data obtained at the time of intubation could be beneficial for establishing appropriate treatment strategies and obtaining informed consent. In this study, we aimed to clarify the association between patient information at the time of intubation and the outcomes of intubated COVID-19 patients.
This retrospective observational study used single-center data from patients with COVID-19. Patients with COVID-19 who were admitted to Osaka Metropolitan University Hospital from April 1, 2020, to March 31, 2022, and under mechanical ventilation were included. The main outcome was defined as the factors related to ventilator weaning; a multivariate analysis was carried out to evaluate the association between patient information at the time of intubation and the outcome.
In total, 146 patients were included in this study. The factors significantly associated with ventilator weaning were age (65-74 years old, adjusted odds ratio [OR], 0.168; 75 years and older, adjusted OR, 0.121), vaccination history (adjusted OR, 5.655), and Sequential Organ Failure Assessment (SOFA) respiration score (adjusted OR, 0.007) at the time of intubation.
Age, SOFA respiration score, and COVID-19 vaccination history at the time of intubation could be associated with outcomes in patients with COVID-19 requiring mechanical ventilation.
冠状病毒病（COVID-19）在全球范围内传播，并被世界卫生组织宣布为大流行病。尽管在过去几年中有大量研究，但与需要机械通气的COVID-19患者预后相关的因素仍不清楚。利用插管时获得的数据预测呼吸机撤机和死亡率，可能有助于制定适当的治疗策略并获得知情同意。在本研究中，我们旨在阐明插管时的患者信息与插管的COVID-19患者预后之间的关联。
这项回顾性观察研究使用了来自COVID-19患者的单中心数据。纳入了2020年4月1日至2022年3月31日期间入住大阪医科大学医院并接受机械通气的COVID-19患者。主要结局定义为与呼吸机撤机相关的因素；进行多因素分析以评估插管时的患者信息与结局之间的关联。
本研究共纳入146例患者。与呼吸机撤机显著相关的因素包括插管时的年龄（65 - 74岁，调整优势比[OR]，0.168；75岁及以上，调整OR，0.121）、疫苗接种史（调整OR，5.655）和序贯器官衰竭评估（SOFA）呼吸评分（调整OR，0.007）。
插管时的年龄、SOFA呼吸评分和COVID-19疫苗接种史可能与需要机械通气的COVID-19患者的预后相关。
