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COVID-19 患者入住重症监护病房的死亡率预测因素:伊朗德黑兰的一项单中心研究。

Predictors of Mortality among COVID-19 Patients Admitted to Intensive Care Units: A Single-Center Study in Tehran, Iran.

机构信息

Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Iran Med. 2022 Oct 1;25(10):676-681. doi: 10.34172/aim.2022.106.

Abstract

BACKGROUND

Iran was one of the first countries to become an epicenter of the coronavirus disease 2019 (COVID-19) epidemic. However, there is a dearth of data on the outcomes of COVID-19 and predictors of death in intensive care units (ICUs) in Iran. We collected extensive data from patients admitted to the ICUs of the one of the tertiary referral hospitals in Tehran, Iran, to investigate the predictors of ICU mortality.

METHODS

The study population included 290 COVID-19 patients who were consecutively admitted to the ICUs of the Sina hospital from May 5, 2021, to December 6, 2021, a period that included the peak of the epidemic of the delta (δ) variant. Demographic data, history of prior chronic diseases, laboratory data (including markers of inflammation), radiologic data, and medication data were collected.

RESULTS

Of the 290 patients admitted to the ICUs, 187 (64.5%) died and 103 (35.5%) survived. One hundred forty-one (141, 48.6%) were men, and the median age (10th percentile, 90th percentile) was 60 (41, 80). Using logistic regression models, older age, history of hypertension, high levels of inflammatory markers, low oxygen saturation, substantial lung involvement in computed tomography (CT) scans, and gravity of the disease as indicated by the WHO 8-point ordinal scale were primary predictors of mortality at ICU. The use of remdesivir and imatinib was associated with a statistically non-significant reduction in mortality. The use of tocilizumab had almost no effect on mortality.

CONCLUSION

The findings are consistent with and add to the currently existing international literature. The findings may be used to predict risk of mortality from COVID-19 and provide some guidance on potential treatments.

摘要

背景

伊朗是首批成为 2019 年冠状病毒病(COVID-19)疫情中心的国家之一。然而,伊朗关于 COVID-19 结局和重症监护病房(ICU)死亡预测因素的数据却很少。我们从伊朗德黑兰一家三级转诊医院的 ICU 收治的患者中收集了广泛的数据,以调查 ICU 死亡率的预测因素。

方法

研究人群包括 290 名 COVID-19 患者,他们于 2021 年 5 月 5 日至 2021 年 12 月 6 日期间连续入住 Sina 医院的 ICU,这一时期包括 delta(δ)变异株流行的高峰期。收集了人口统计学数据、既往慢性疾病史、实验室数据(包括炎症标志物)、影像学数据和药物治疗数据。

结果

在入住 ICU 的 290 名患者中,187 名(64.5%)死亡,103 名(35.5%)存活。141 名(48.6%)为男性,中位年龄(第 10 百分位数,第 90 百分位数)为 60(41,80)。使用逻辑回归模型,年龄较大、高血压史、炎症标志物水平较高、氧饱和度较低、计算机断层扫描(CT)扫描中肺部受累广泛以及世界卫生组织 8 点序数量表所示疾病严重程度是 ICU 死亡率的主要预测因素。瑞德西韦和伊马替尼的使用与死亡率的统计学显著降低相关。托珠单抗的使用对死亡率几乎没有影响。

结论

这些发现与目前现有的国际文献一致,并对其进行了补充。这些发现可用于预测 COVID-19 死亡率的风险,并为潜在治疗方法提供一些指导。

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