Navas Boada Paulo, Chamorro Kevin, Ballaz Santiago
School of Biological Sciences and Engineering Universidad Yachay Tech.
School of Mathematics and Computational Sciences Universidad Yachay Tech.
Can J Respir Ther. 2024 Aug 21;60:112-121. doi: 10.29390/001c.122402. eCollection 2024.
BACKGROUND/AIM: This study analyzed clinical factors impacting the survival of COVID-19 patients with acute respiratory distress síndrome, or ARDS (CARDS) to ICU compared to non-COVID-19 ARDS patients.
Clinical variables from 1,008 CARDS cases and 332 ARDS cases were computed using learning algorithms. The multivariable Cox proportional hazards regression models with the enter method evaluated risk factors and ICU mortality relationships. The survival analysis was completed with Kaplan-Meier and the log-rank tests.
A Random Forest model revealed that mechanical ventilation-related factors, oxygenation, blood pH, superinfection, shock, and ICU length of stay have the greatest effects on ICU survival. According to a multivariate Cox model, reintubation and a high-flow nasal cannula were essential for survival in CARDS patients during the ICU stay. The length of stay in the ICU diminishes in patients older than 45 years, regardless of the source of ARDS.
This study gives recommendations for the respiratory care of ARDS in COVID-19 patients.
背景/目的：本研究分析了与非新冠肺炎急性呼吸窘迫综合征（ARDS）患者相比，影响新冠肺炎急性呼吸窘迫综合征（CARDS）患者入住重症监护病房（ICU）后生存的临床因素。
使用学习算法计算1008例CARDS病例和332例ARDS病例的临床变量。采用逐步回归法的多变量Cox比例风险回归模型评估风险因素与ICU死亡率的关系。生存分析采用Kaplan-Meier法和对数秩检验完成。
随机森林模型显示，机械通气相关因素、氧合、血液pH值、二重感染、休克和ICU住院时间对ICU生存影响最大。根据多变量Cox模型，再次插管和高流量鼻导管对CARDS患者在ICU住院期间的生存至关重要。无论ARDS的病因如何，45岁以上患者的ICU住院时间都会缩短。
本研究为新冠肺炎患者ARDS的呼吸护理提供了建议。
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