荷兰重症监护医学科收治的新冠肺炎患者的长期死亡率：一项基于国家质量登记处的回顾性分析。
Long-term mortality of Dutch COVID-19 patients admitted to the intensive care medicine: a retrospective analysis from a national quality registry.
作者信息
Wortel Safira A, Bakhshi-Raiez Ferishta, Abu-Hanna Ameen, Dongelmans Dave A, Keizer Nicolette F de, Houwink Aletta, Dijkhuizen Allard, Draisma Annelies, Rijkeboer Annemiek, Cloïn Arjan, Meijer Arthur de, Reidinga Auke, Festen-Spanjer Barbara, van Bussel Bas, Eikemans Bob, Jacobs Cretièn, Moolenaar David, Ramnarain Dharmanand, Koning Dick, Boer Dirk, Verbiest Dirk, van Slobbe-Bijlsma Eline, van Koppen Ellen, Rengers Els, van Driel Erik, Verweij Eva, van Iersel Freya, Brunnekreef Gert, Kieft Hans, Kreeftenberg Herman, Hené Ilanit, Janssen Inge, Drogt Ionana, van der Horst Iwan, Spijkstra Jan Jaap, Rozendaal Jan, Mehagnoul-Schipper Jannet, Erasmus Jelle Epker, Holtkamp Jessica, Lutisan Johan, van Oers Jos, Lens Judith, van Gulik Laura, van den Berg Lettie, Urlings-Strop Louise, Georgieva Lyuba, van Lieshout Maarten, Hoogendoorn Marga, Mos Marissa Vrolijk-de, Graaff Mart de, Bruin Martha de, Hoeksema Martijn, van Tellingen Martijn, Barnas Michel, Erkamp Michiel, Gritters Niels, Kusadasi Nuray, Elbers Paul, Koetsier Peter, Spronk Peter, van der Voort Peter, Pruijsten Ralph, Jong Remko de, Bosman Robert-Jan, Wesselink Ronald, Schnabel Ronny, van den Berg Roy, Waal Ruud de, Arbous Sesmu, Knape Silvia, Hendriks Stefaan, Frenzel Tim, Dormans Tom, Rijpstra Tom, Silderhuis Vera, Ruijter Wouter de
机构信息
Department of Medical Informatics, Amsterdam University Medical Center, University of Amsterdam - Amsterdam, The Netherlands.
National Intensive Care Evaluation (NICE) Foundation - Amsterdam, The Netherlands.
出版信息
Crit Care Sci. 2024 Dec 20;36:e202400251en. doi: 10.62675/2965-2774.20240251-en. eCollection 2024.
OBJECTIVE
To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use.
METHODS
We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup. We used Cox regression models to analyze the effects of patient characteristics on 12-month mortality after hospital discharge.
RESULTS
We included 16,605 COVID-19 patients. The in-hospital mortality rate was 28.1%, and the 12-month mortality rate after intensive care unit admission was 29.8%. Among hospital survivors, 12-month mortality after hospital discharge was 2.5% (300/11,931). The hazard of death at 12 months after hospital discharge was greater in patients between 60 and 79 years (HR 4.74; 95%CI 2.23 - 10.06) and ≥ 80 years (HR 22.77; 95%CI 9.91 - 52.28) than in patients < 40 years of age; in male patients than in female patients (HR 1.38; 95%CI 1.07 - 1.78); and in patients with one (adjusted HR 1.95; 95%CI 1.5 - 2.53), two (adjusted HR 4.49; 95%CI 3.27 - 6.16) or more than two comorbidities (adjusted HR 4.99; 95%CI 2.62 - 9.5) than in patients with no comorbidities. Neither vasoactive medication use nor mechanical ventilation resulted in statistically significant results.
CONCLUSION
For Dutch COVID-19 intensive care unit patients, most deaths occurred during their hospital stay. For hospital survivors, the crude 12-month mortality rate was low. Patient age (older than 60), sex and the number of comorbidities were associated with a greater hazard of death at 12 months after hospital discharge, whereas mechanical ventilation and vasoactive medication were not.
目的
基于合并症数量、年龄、性别、机械通气及血管活性药物使用情况，描述荷兰新冠肺炎重症监护病房患者、新冠肺炎总体人群及各亚组的12个月死亡率。
方法
我们纳入了2020年3月1日至2022年3月29日期间从荷兰国家重症监护（NICE）数据库收治的所有新冠肺炎患者。通过Kaplan-Meier生存曲线呈现每个患者亚组的粗12个月死亡率。我们使用Cox回归模型分析患者特征对出院后12个月死亡率的影响。
结果
我们纳入了16605例新冠肺炎患者。住院死亡率为28.1%，重症监护病房入院后12个月死亡率为29.8%。在医院幸存者中，出院后12个月死亡率为2.5%（300/11931）。出院后12个月时，60至79岁患者（HR 4.74；95%CI 2.23 - 10.06）和≥80岁患者（HR 22.77；95%CI 9.91 - 52.28）的死亡风险高于<40岁患者；男性患者高于女性患者（HR 1.38；95%CI 1.07 - 1.78）；有1种（调整后HR 1.95；95%CI 1.5 - 2.53）、2种（调整后HR 4.49；95%CI 3.27 - 6.16）或2种以上合并症的患者（调整后HR 4.99；95%CI 2.62 - 9.5）高于无合并症患者。血管活性药物使用和机械通气均未产生具有统计学意义的结果。
结论
对于荷兰新冠肺炎重症监护病房患者，大多数死亡发生在住院期间。对于医院幸存者，粗12个月死亡率较低。患者年龄（60岁以上）、性别和合并症数量与出院后12个月时较高的死亡风险相关，而机械通气和血管活性药物则不然。
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