2019冠状病毒病之前和2019冠状病毒病时代接受静脉-静脉体外膜肺氧合治疗的患者中的种族差异：一项回顾性注册研究。
Racial disparities among patients on venovenous extracorporeal membrane oxygenation in the pre-Coronavirus Disease 2019 and Coronavirus Disease 2019 eras: A retrospective registry review.
作者信息
Enumah Zachary Obinna, Etchill Eric W, Kim Bo Soo, Giuliano Katherine A, Kalra Andrew, Cho Sung-Min, Whitman Glenn J R, Ha Jinny S, Choi Chun Woo, Higgins Robert S D, Bush Errol L
机构信息
Department of Surgery, Johns Hopkins Hospital, Baltimore, Md.
Pulmonary and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Md.
出版信息
JTCVS Open. 2023 Dec 23;17:162-171. doi: 10.1016/j.xjon.2023.12.008. eCollection 2024 Feb.
OBJECTIVES
Although many studies have addressed such disparities caused by COVID-19, to our knowledge, no study has focused on the association of race on outcomes for patients with COVID-19 requiring venovenous extracorporeal membrane oxygenation support. The goal of this study was to assess association of race on death and duration on venovenous extracorporeal membrane oxygenation in both the pre-COVID-19 and COVID-19 eras.
METHODS
We retrospectively reviewed the Extracorporeal Life Support Organization registry and included adults (≥18 years) who required venovenous extracorporeal membrane oxygenation between January 2019 and April 2021. We performed descriptive statistics and multivariable logistic regression. Our primary outcomes were death and extracorporeal membrane oxygenation duration.
RESULTS
A total of 7477 patients were included after excluding 340 patients (4.3%) who were missing race data. In the COVID-19 era, 1474 of 2777 COVID-19-positive patients (53.1%) died. Our regression model suggested somewhat of a protective effect on death for Black and multiple race patients. Additionally, a diagnosis of COVID-19 and patients in the COVID-19 era in general, irrespective of COVID-19 diagnosis, had higher odds of death. Hispanic patients had the longest average venovenous extracorporeal membrane oxygenation run times.
CONCLUSIONS
Our study using data from the international Extracorporeal Life Support Organization Registry provides updated data on patients supported with venovenous extracorporeal membrane oxygenation in the pre-COVID-19 and COVID-19 eras between 2019 and 2021 with a focus on race. Patients in the COVID-19 era group also had higher mortality compared with those in the pre-COVID-19 era even after being adjusted for COVID-19 diagnosis. Black and multiple races appeared somewhat protective in terms of death. Hispanic race was associated with longer venovenous extracorporeal membrane oxygenation duration.
目的
尽管许多研究都探讨了由新冠病毒病（COVID-19）导致的此类差异，但据我们所知，尚无研究关注种族与需要静脉-静脉体外膜肺氧合支持的COVID-19患者预后之间的关联。本研究的目的是评估在COVID-19之前和COVID-19时代，种族与静脉-静脉体外膜肺氧合治疗的死亡及持续时间之间的关联。
方法
我们回顾性分析了体外生命支持组织登记处的数据，纳入了2019年1月至2021年4月期间需要静脉-静脉体外膜肺氧合的成年人（≥18岁）。我们进行了描述性统计和多变量逻辑回归分析。我们的主要结局指标是死亡和体外膜肺氧合持续时间。
结果
在排除340例（4.3%）种族数据缺失的患者后，共纳入7477例患者。在COVID-19时代，2777例COVID-19阳性患者中有1474例（53.1%）死亡。我们的回归模型显示，黑人及多种族患者在死亡方面似乎有一定的保护作用。此外，COVID-19诊断以及一般而言COVID-19时代的患者，无论是否有COVID-19诊断，死亡几率都更高。西班牙裔患者的静脉-静脉体外膜肺氧合平均运行时间最长。
结论
我们利用国际体外生命支持组织登记处的数据进行的研究，提供了2019年至2021年COVID-19之前和COVID-19时代接受静脉-静脉体外膜肺氧合支持患者的最新数据，重点关注种族因素。即使在对COVID-19诊断进行调整后，COVID-19时代组的患者死亡率也高于COVID-19之前的时代。黑人及多种族在死亡方面似乎有一定保护作用。西班牙裔种族与更长的静脉-静脉体外膜肺氧合持续时间相关。
Zotero 插件