Emergency department of regional hospital of Ben Arous.
Tunis Med. 2024 Feb 5;102(2):78-82. doi: 10.62438/tunismed.v102i2.4659.
The overcrowding of intensive care units during the corona virus pandemic increased the number of patients managed in the emergency department (ED). The detection timely of the predictive factors of mortality and bad outcomes improve the triage of those patients.
To define the predictive factors of mortality at 30 days among patients admitted on ED for covid-19 pneumonia.
This was a prospective, monocentric, observational study for 6 months. Patients over the age of 16 years admitted on the ED for hypoxemic pneumonia due to confirmed SARS-COV 2 infection by real-time reverse-transcription polymerase chain reaction (rRT-PCR) were included. Multivariate logistic regression was performed to investigate the predictive factors of mortality at 30 days.
463 patients were included. Mean age was 65±14 years, Sex-ratio=1.1. Main comorbidities were hypertension (49%) and diabetes (38%). Mortality rate was 33%. Patients who died were older (70±13 vs. 61±14;p<0.001), and had more comorbidities: hypertension (57% vs. 43%, p=0.018), chronic heart failure (8% vs. 3%, p=0.017), and coronary artery disease (12% vs. 6%, p=0.030). By multivariable analysis, factors independently associated with 30-day mortality were age ≥65 years aOR: 6.9, 95%CI 1.09-44.01;p=0.04) SpO2<80% (aOR: 26.6, 95%CI 3.5-197.53;p=0.001) and percentage of lung changes on CT scan>70% (aOR: 5.6% 95%CI .01-31.29;p=0.04).
Mortality rate was high among patients admitted in the ED for covid-19 pneumonia. The identification of predictive factors of mortality would allow better patient management.
在冠状病毒大流行期间，重症监护病房人满为患，导致在急诊科（ED）接受治疗的患者数量增加。及时发现死亡和不良预后的预测因素可以改善这些患者的分诊。
确定因 COVID-19 肺炎入住 ED 的患者在 30 天时的死亡预测因素。
这是一项为期 6 个月的前瞻性、单中心、观察性研究。纳入年龄在 16 岁以上，因实时逆转录聚合酶链反应（rRT-PCR）证实 SARS-COV 2 感染而导致低氧性肺炎，入住 ED 的患者。采用多变量逻辑回归分析调查 30 天时的死亡预测因素。
共纳入 463 例患者。平均年龄为 65±14 岁，性别比为 1.1。主要合并症为高血压（49%）和糖尿病（38%）。死亡率为 33%。死亡患者年龄较大（70±13 岁 vs. 61±14 岁；p<0.001），且合并症更多：高血压（57% vs. 43%，p=0.018）、慢性心力衰竭（8% vs. 3%，p=0.017）和冠心病（12% vs. 6%，p=0.030）。多变量分析显示，与 30 天死亡率相关的独立因素为年龄≥65 岁（aOR：6.9，95%CI 1.09-44.01；p=0.04）、SpO2<80%（aOR：26.6，95%CI 3.5-197.53；p=0.001）和 CT 扫描上肺改变百分比>70%（aOR：5.6%，95%CI 0.01-31.29；p=0.04）。
因 COVID-19 肺炎入住 ED 的患者死亡率较高。识别死亡预测因素可改善患者管理。
