Khazaeipour Zahra, Gholamzadeh Marsa, Behnoush Amir Hossein, Pestei Khalil
Brain and Spinal Cord Injury Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran Iran.
Health Information Management and Medical Informatics Department, School of Allied Medical Sciences Tehran University of Medical Sciences Tehran Iran.
Health Sci Rep. 2024 Sep 5;7(9):e70045. doi: 10.1002/hsr2.70045. eCollection 2024 Sep.
COVID-19 patients might be admitted to the hospital based on their clinical manifestations or to the intensive care unit (ICU) due to the severity of their symptoms or critical situation. Our main objective was to investigate clinical and demographic factors influencing COVID-19 patients' admission to the ICU and length of stay (LOS) using extracted data from the hospital information systems in Iran.
The data of hospitalized patients with confirmed COVID-19 were retrieved from the health information system of Imam Khomeini Hospital Complex, Tehran, Iran between March 2020 and February 2022. The primary outcome was the ICU admission, and the secondary outcome was the LOS. The correlation analysis between laboratory findings and demographic data with ICU admission and LOS was done using SPSS 21.0, and < 0.05 was considered significant.
Of all the 4156 patients, 2391 (57.5%) were male and the mean age was 58.69 ± 8.19 years. Of these, 9.5% of patients were admitted to ICU at any time point during their hospital stay. Age and laboratory variables such as neutrophil-to-lymphocyte ratio (NLR), ALT (U/L), albumin (g/dL), plasma glucose (mg/dL), ferritin levels (ng/mL), and phosphorous levels (mg/dL) shown the significant relationship with ICU admission. Also, being a smoker and having hypoxemia had a significant relationship with longer stays in the hospital. In this study, we validated a cut-off value of 4.819 for NLR, calculated at hospitalization, as a useful predictor of disease progression and occurrence of serious clinical outcomes, such as ICU admission.
The study examined various clinical factors associated with ICU admission in COVID-19 patients. The findings suggest that certain factors can increase the risk of ICU admission and influence the length of hospital stay which should be focused in future studies.
COVID-19患者可能因其临床表现而入院，或因症状严重或病情危急而入住重症监护病房（ICU）。我们的主要目标是利用从伊朗医院信息系统提取的数据，调查影响COVID-19患者入住ICU及住院时间（LOS）的临床和人口统计学因素。
2020年3月至2022年2月期间，从伊朗德黑兰伊玛目霍梅尼医院综合健康信息系统中检索确诊COVID-19的住院患者数据。主要结局是入住ICU，次要结局是住院时间。使用SPSS 21.0对实验室检查结果和人口统计学数据与入住ICU及住院时间进行相关性分析，P < 0.05被认为具有统计学意义。
在所有4156例患者中，2391例（57.5%）为男性，平均年龄为58.69 ± 8.19岁。其中，9.5%的患者在住院期间的任何时间点入住ICU。年龄以及中性粒细胞与淋巴细胞比值（NLR）、谷丙转氨酶（U/L）、白蛋白（g/dL）、血糖（mg/dL）、铁蛋白水平（ng/mL）和磷水平（mg/dL）等实验室变量与入住ICU显著相关。此外，吸烟和低氧血症与住院时间延长显著相关。在本研究中，我们验证了住院时计算的NLR临界值4.819作为疾病进展和严重临床结局（如入住ICU）发生的有用预测指标。
本研究探讨了与COVID-19患者入住ICU相关的各种临床因素。研究结果表明，某些因素可增加入住ICU的风险并影响住院时间，这应是未来研究的重点。
