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使用心血管风险指数预测急性呼吸窘迫综合征新冠病毒感染患者的死亡率:一项横断面研究。

Using cardiovascular risk indices to predict mortality in Covid-19 patients with acute respiratory distress syndrome: a cross sectional study.

机构信息

Division of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.

出版信息

Sci Rep. 2023 Jul 15;13(1):11452. doi: 10.1038/s41598-023-38732-3.

Abstract

Covid-19 patients who require admission to an intensive care unit (ICU) have a higher risk of mortality. Several risk factors for severe Covid-19 infection have been identified, including cardiovascular risk factors. Therefore, the aim was to investigate the association between cardiovascular (CV) risk and major adverse cardiovascular events (MACE) and mortality of Covid-19 ARDS patients admitted to an ICU. A prospective cross-sectional study was conducted in a university hospital in Graz, Austria. Covid-19 patients who were admitted to an ICU with a paO2/fiO2 ratio < 300 were included in this study. Standard lipid profile was measured at ICU admission to determine CV risk. 31 patients with a mean age of 68 years were recruited, CV risk was stratified using Framingham-, Procam- and Charlson Comorbidity Index (CCI) score. A total of 10 (32.3%) patients died within 30 days, 8 patients (25.8%) suffered from MACE during ICU stay. CV risk represented by Framingham-, Procam- or CCI score was not associated with higher rates of MACE. Nevertheless, higher CV risk represented by Procam score was significantly associated with 30- day mortality (13.1 vs. 6.8, p = 0.034). These findings suggest that the Procam score might be useful to estimate the prognosis of Covid-19 ARDS patients.

摘要

需要入住重症监护病房(ICU)的 COVID-19 患者的死亡率更高。已经确定了 COVID-19 感染的几个严重风险因素,包括心血管风险因素。因此,本研究旨在探讨 ICU 收治的 COVID-19 急性呼吸窘迫综合征(ARDS)患者的心血管(CV)风险与主要不良心血管事件(MACE)和死亡率之间的关系。这项前瞻性横断面研究在奥地利格拉茨的一所大学医院进行。本研究纳入了因 paO2/fiO2 比<300 而入住 ICU 的 COVID-19 患者。在 ICU 入院时测量标准血脂谱以确定 CV 风险。共纳入 31 名平均年龄为 68 岁的患者,使用 Framingham、Procam 和 Charlson 合并症指数(CCI)评分对 CV 风险进行分层。在 30 天内,共有 10 名(32.3%)患者死亡,8 名(25.8%)患者在 ICU 期间发生 MACE。Framingham、Procam 或 CCI 评分代表的 CV 风险与更高的 MACE 发生率无关。然而,Procam 评分代表的较高 CV 风险与 30 天死亡率显著相关(13.1%比 6.8%,p=0.034)。这些发现表明,Procam 评分可能有助于评估 COVID-19 ARDS 患者的预后。

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