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新型冠状病毒肺炎重症监护病房幸存者再入院的危险因素:一项为期三年的随访研究

Risk factors for readmission of COVID-19 ICU survivors: A three-year follow up.

作者信息

Caamaño Estrela, Rodrigo Laura Velasco, Garcia-Ramos Sergio, Garcia Alberto Calvo, Cerro Silvia Ramos, Power Mercedes, Asencio Jose Manuel, Piñeiro Patricia, Hortal Javier, Garutti Ignacio

机构信息

Department of Anaesthesiology and Critical Care Medicine, Gregorio Maranon National Hospital, Madrid, Spain.

Universidad Complutense de Madrid (UCM), Madrid, Spain.

出版信息

Indian J Med Res. 2025 Feb;161(2):190-198. doi: 10.25259/IJMR_726_2024.

Abstract

Background & objectives Evidence suggests that individuals who have been hospitalised due to COVID-19 are more susceptible to future mortality and readmission, thereby imposing a substantial strain on their quality of life. The available data on intensive care unit (ICU) survivors, particularly in terms of long-term outcomes, is notably insufficient. This study focused on the long-term outcomes for ICU survivors of COVID-19, specifically readmission and mortality, as well as possible risk factors that could lead to their need for readmission. Methods We conducted a prospective observational study of 505 individuals admitted to the ICU of a tertiary care hospital between March 2020 and March 2021. Follow up concluded in January 2024. We evaluated the need for hospital and ICU readmissions, examining potential risk factors, including patient comorbidities, clinical situation at the time of the previous hospital and ICU admission, and evolution and treatment in the ICU. As a secondary objective, we determined the prevalence of long-term mortality. Results Among 341 ICU survivors, 75 (22%) required hospital readmission, with a median time to readmission of 415 days (IQR: 166-797). The most frequent cause of readmission was respiratory conditions (29.3%). The median hospital stay during readmission was six days. Independent risk factors for hospital readmission included age, elevated creatinine levels at ICU admission, and length of stay in the ICU. Of the 75 readmitted to the hospital, 19 required ICU readmission. Ten individuals died following hospital discharge. Interpretation & conclusions Patients requiring ICU admission due to COVID-19 have a significant risk of hospital readmission, particularly those with advanced age, elevated creatinine levels at ICU admission, and longer ICU stays.

摘要

背景与目的 有证据表明,因新冠病毒病(COVID-19)住院的个体未来死亡和再入院风险更高,这对他们的生活质量造成了巨大压力。关于重症监护病房(ICU)幸存者的现有数据,尤其是长期预后方面的数据明显不足。本研究聚焦于COVID-19的ICU幸存者的长期预后,特别是再入院情况和死亡率,以及可能导致他们需要再次入院的风险因素。方法 我们对2020年3月至2021年3月期间入住一家三级医院ICU的505名患者进行了一项前瞻性观察研究。随访于2024年1月结束。我们评估了再次入院至医院和ICU的需求,检查了潜在风险因素,包括患者的合并症、上次住院和ICU入院时的临床情况以及在ICU的病情演变和治疗情况。作为次要目标,我们确定了长期死亡率的患病率。结果 在341名ICU幸存者中,75名(22%)需要再次入院至医院,再次入院的中位时间为415天(四分位间距:166 - 797天)。再次入院最常见的原因是呼吸道疾病(29.3%)。再次入院期间的中位住院时间为6天。再次入院至医院的独立风险因素包括年龄、ICU入院时肌酐水平升高以及在ICU的住院时间。在75名再次入院至医院的患者中,19名需要再次入院至ICU。10名患者在出院后死亡。解读与结论 因COVID-19需要入住ICU的患者再次入院至医院的风险很高,尤其是那些年龄较大、ICU入院时肌酐水平升高且在ICU住院时间较长的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a3/12010781/8823281eb8f7/IJMR-161-2-190-g1.jpg

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