Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru.
Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru.
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DOI：
10.1371/journal.pone.0244171
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Málaga G
中科院分区：
文献类型：
--
作者：
Mejía F;Medina C;Cornejo E;Morello E;Vásquez S;Alave J;Schwalb A;Málaga G
秘鲁是全球2019冠状病毒病（COVID-19）病例数最多的十大国家之一。该研究的目的是描述住院成人COVID-19患者的临床特征，并确定与住院死亡率相关的预后因素。我们在秘鲁利马的三级护理医院卡耶塔诺埃雷迪亚医院收治的COVID-19成人患者中进行了一项回顾性队列研究。主要结局为住院死亡率。多变量考克斯比例风险回归用于识别与住院死亡率独立相关的因素。共纳入369例患者（中位年龄59岁[IQR：49-68]; 241例（65.31%）男性）。大多数患者（68.56%）报告至少一种合并症;更常见的是：肥胖（42.55%）、糖尿病（21.95%）和高血压（21.68%）。入院前症状的中位持续时间为7天（IQR：5-10）。报告的住院死亡率为49.59%。多元考克斯回归分析显示，入院时血氧饱和度（SaO 2）值低于90%与死亡率相关，为1.86（95%CI：1.02-3.39），4.44（95%CI：2.46-8.02）和7.74与SaO 2> 90%的患者相比，SaO 2为89- 85%、84-80%和<80%的患者的死亡风险分别高（95%CI：4.54-13.19）倍。此外，年龄>60岁与1.88倍的死亡率相关。入院时血氧饱和度低于90%是COVID-19患者住院死亡率的有力预测因素。在资源有限的情况下，降低COVID-19死亡率的努力应侧重于早期发现低氧血症并及时获得医院护理。
Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality. We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality. A total of 369 patients (median age 59 years [IQR:49–68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5–10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02–3.39), 4.44 (95%CI: 2.46–8.02) and 7.74 (95%CI: 4.54–13.19) times greater risk of death for SaO2 of 89–85%, 84–80% and <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality. Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.
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DOI：
10.1152/ajpendo.00124.2020
发表时间：
2020-05-01
影响因子：
5.1
作者：
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影响因子：
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