基于倾向评分匹配对入住重症监护病房的新冠肺炎患者与其他社区获得性肺炎患者的结局和特征进行比较。
Comparison of outcomes and characteristics of patients admitted to the ICU with COVID-19 and other community-acquired pneumonia based on propensity score matching.
作者信息
Zhao Hongli, Yan Xiulin, Guo Ziru, Li Kaiyu, Wang Zhaopeng, Wang Jun, Lv Dong, Zhu Jianling, Chen Ye
机构信息
Department of Critical Care Medicine, Datong Third People's Hospital, Datong, Shanxi, China.
Science and Education Section, Datong Third People's Hospital, Datong, Shanxi, China.
出版信息
BMC Infect Dis. 2024 Apr 22;24(1):419. doi: 10.1186/s12879-024-09306-z.
OBJECTIVE
To compare the similarities and differences between patients with Coronavirus Disease 2019 (COVID-19) and those with other community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU), utilizing propensity score matching (PSM), regarding hospitalization expenses, treatment options, and prognostic outcomes, aiming to inform the diagnosis and treatment of COVID-19.
METHODS
Patients admitted to the ICU of the Third People's Hospital of Datong City, diagnosed with COVID-19 from December 2022 to February 2023, constituted the observation group, while those with other CAP admitted from January to November 2022 formed the control group. Basic information, clinical data at admission, and time from symptom onset to admission were matched using PSM.
RESULTS
A total of 70 patients were included in the COVID-19 group and 119 in the CAP group. The patients were matched by the propensity matching method, and 37 patients were included in each of the last two groups. After matching, COVID-19 had a higher failure rate than CAP, but the difference was not statistically significant (73% vs. 51%, p = 0.055). The utilization rate of antiviral drugs (40% vs. 11%, p = 0.003), γ-globulin (19% vs. 0%, p = 0.011) and prone position ventilation (PPV) (27% vs. 0%, p < 0.001) in patients with COVID-19 were higher than those in the CAP, and the differences were statistically significant. The total hospitalization cost of COVID-19 patients was lower than that of CAP patients, and the difference was statistically significant (27889.5 vs. 50175.9, p = 0.007). The hospital stay for COVID-19 patients was shorter than for CAP patients, but the difference was not statistically significant (10.9 vs. 16.6, p = 0.071).
CONCLUSION
Our findings suggest that limited medical resources influenced patient outcomes during the COVID-19 pandemic. Addressing substantial demands for ICU capacity and medications during this period could have potentially reduced the mortality rate among COVID-19 patients.
目的
利用倾向评分匹配法（PSM）比较入住重症监护病房（ICU）的2019冠状病毒病（COVID-19）患者与其他社区获得性肺炎（CAP）患者在住院费用、治疗方案和预后结果方面的异同，旨在为COVID-19的诊断和治疗提供参考。
方法
将2022年12月至2023年2月在大同市第三人民医院ICU确诊为COVID-19的患者作为观察组，将2022年1月至11月收治的其他CAP患者作为对照组。采用PSM对基本信息、入院时的临床资料以及症状出现到入院的时间进行匹配。
结果
COVID-19组共纳入70例患者，CAP组纳入119例。采用倾向匹配法对患者进行匹配，最后两组各纳入37例。匹配后，COVID-19的失败率高于CAP，但差异无统计学意义（73%对51%，p = 0.055）。COVID-19患者抗病毒药物的使用率（40%对11%，p = 0.003）、γ-球蛋白的使用率（19%对0%，p = 0.011）和俯卧位通气（PPV）的使用率（27%对0%，p < 0.001）均高于CAP患者，差异有统计学意义。COVID-19患者的总住院费用低于CAP患者，差异有统计学意义（27889.5对50175.9，p = 0.007）。COVID-19患者的住院时间短于CAP患者，但差异无统计学意义（10.9对16.6，p = 0.071）。
结论
我们的研究结果表明，在COVID-19大流行期间，有限的医疗资源影响了患者的预后。在此期间满足对ICU容量和药物的大量需求可能会潜在降低COVID-19患者的死亡率。
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