JAMA Intern Med:与重症新冠肺炎患者死亡相关的人口统计学、临床和医院因素研究

2020-07-21 MedSci原创 MedSci原创

本项研究确定了可能与COVID-19危重患者死亡相关的人口统计学、临床和医院因素,并有助于确定药物和支持性治疗以改善预后

目前美国是2019年冠状病毒病(COVID-19)大流行的震中,但关于COVID-19重症疾病患者特征、治疗和预后的数据却十分有限。近日研究人员评估了COVID-19患者死亡相关因素,并检查COVID-19患者治疗和预后的医院间差异。
 
2215名经实验室证实的COVID-19成人患者参与研究,于2020年3月4日至4月4日在美国65家医院的重症监护病房(ICU)接受治疗。患者数据,包括人口统计学、共病和器官功能障碍,以及医院特征,包括ICU床位数。研究的主要结果是28天住院死亡率。
 
患者平均年龄60.5岁,1436名(64.8%)男性;1738名(78.5%)至少有一种慢性共病。在ICU入院后28天,784例患者(35.4%)死亡,824例(37.2%)出院,607例(27.4%)仍住院治疗。在研究结束后的随访中(中位数,16天),875名患者(39.5%)死亡,1203名(54.3%)出院,137名(6.2%)仍在住院治疗。与死亡独立相关的风险因素包括ICU入院时年龄较大(≥80岁vs<40岁:优势比[OR]=11.15)、男性(OR=1.50),较高的体重指数(≥40 vs<25:OR,1.51)、冠心病(OR,1.47)、活动性癌症(OR,2.15),低氧血症(Pao2:Fio2<100 vs ≥300 mm Hg: OR:2.94)、肝功能障碍(肝序贯性器官衰竭评估得分为2 vs 0:OR,2.61)以及肾功能障碍(肾序贯性器官衰竭评估得分为4 vs 0:OR,2.43)。住院医院ICU床位较少患者的死亡风险较高(ICU 床位<50 vs ≥100: OR, 3.28)。各个医院间患者死亡率差异显著(范围为6.6%-80.8%)且采用羟氯喹、IL-6单抗及其他支持性治疗率差异较大。
 
本项研究确定了可能与COVID-19危重患者死亡相关的人口统计学、临床和医院因素,并有助于确定药物和支持性治疗以改善预后。
 
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    2021-04-09 ms6000000252401279

    学习,分享

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    2020-07-23 siiner
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    2020-07-21 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2020-07-21 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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