Perlaza Claudia Lorena, Cruz Mosquera Freiser Eceomo, Moreno Reyes Sandra Patricia, Tovar Salazar Sandra Marcela, Cruz Rojas Andrés Fernando, España Serna Juan Daniel, Liscano Yamil
Grupo de Investigación en Salud Integral (GISI), Departamento Facultad de Salud, Universidad Santiago de Cali, Cali 5183000, Colombia.
Healthcare (Basel). 2024 Nov 16;12(22):2294. doi: 10.3390/healthcare12222294.
The COVID-19 pandemic posed significant challenges to healthcare systems worldwide, and mortality rates were driven by a complex interaction of patient-specific factors, one of the most important being those related to the scheduling of invasive mechanical ventilation. This study examined the sociodemographic, clinical, and ventilatory factors associated with mortality in COVID-19 patients admitted to the ICU of a hospital in Colombia.
A retrospective cohort study was conducted, involving 116 patients over the age of 18 who were admitted to the ICU with a confirmed diagnosis of COVID-19 between March 2020 and May 2021. Data were collected from the patients' medical records. Statistical analysis was performed using SPSS version 24. Odds ratios (OR) and 95% confidence intervals were calculated to identify factors associated with COVID-19 mortality, followed by adjustment through binary logistic regression.
It was found that 65.5% of the patients were male, with a mean age of 64 ± 14 years, and the overall mortality rate was 49%. Factors significantly associated with higher mortality included male sex (OR: 6.9, 95% CI: 1.5-31.7), low oxygen saturation on admission (OR: 7.6, 95% CI: 1.1-55), and PEEP settings at 96 h (OR: 8, 95% CI: 1.4-45). Mortality was not influenced by socioeconomic status or health system affiliation.
This study identified male sex, age over 65 years, PEEP greater than 10 cmHO at 96 h of mechanical ventilation, and low oxygen saturation as significant factors associated with higher mortality in COVID-19 patients, while no significant associations were found with socioeconomic status or health system affiliation. These findings highlight the importance of focusing on clinical management and ventilatory strategies in reducing mortality, particularly for high-risk groups, rather than relying on socioeconomic factors as predictors of outcomes.
新冠疫情给全球医疗系统带来了巨大挑战，死亡率受到患者个体因素复杂相互作用的影响，其中最重要的因素之一是与有创机械通气时机相关的因素。本研究调查了哥伦比亚一家医院重症监护病房收治的新冠患者中与死亡相关的社会人口学、临床和通气因素。
进行了一项回顾性队列研究，纳入了2020年3月至2021年5月期间因确诊新冠而入住重症监护病房的116名18岁以上患者。从患者病历中收集数据。使用SPSS 24版进行统计分析。计算比值比（OR）和95%置信区间以确定与新冠死亡率相关的因素，随后通过二元逻辑回归进行调整。
发现65.5%的患者为男性，平均年龄为64±14岁，总体死亡率为49%。与较高死亡率显著相关的因素包括男性（OR：6.9，95%CI：1.5 - 31.7）入院时低氧饱和度（OR：7.6，95%CI：1.1 - 55）以及96小时时的呼气末正压通气（PEEP）设置（OR：8，95%CI：1.4 - 45）。死亡率不受社会经济地位或卫生系统所属关系的影响。
本研究确定男性、65岁以上年龄以及机械通气96小时时呼气末正压通气大于等于10 cmH₂O、低氧饱和度是新冠患者死亡率较高的显著相关因素，而未发现与社会经济地位或卫生系统所属关系有显著关联。这些发现凸显了在降低死亡率方面关注临床管理和通气策略的重要性，特别是对于高危人群，而不是依赖社会经济因素作为预后预测指标。
