In-hospital mortality from severe COVID-19 in a tertiary care center in Mexico City; causes of death, risk factors and the impact of hospital saturation.
In-hospital mortality from severe COVID-19 in a tertiary care center in Mexico City; causes of death, risk factors and the impact of hospital saturation.
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墨西哥城的三级护理中心的严重共同19岁的住院死亡率；死亡原因，危险因素和医院饱和的影响。
DOI：
10.1371/journal.pone.0245772
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Sifuentes-Osornio J
中科院分区：
文献类型：
--
作者：
Olivas-Martínez A;Cárdenas-Fragoso JL;Jiménez JV;Lozano-Cruz OA;Ortiz-Brizuela E;Tovar-Méndez VH;Medrano-Borromeo C;Martínez-Valenzuela A;Román-Montes CM;Martínez-Guerra B;González-Lara MF;Hernandez-Gilsoul T;Herrero AG;Tamez-Flores KM;Ochoa-Hein E;Ponce-de-León A;Galindo-Fraga A;Kershenobich-Stalnikowitz D;Sifuentes-Osornio J
由于严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）大流行仍在拉丁美洲持续，墨西哥已成为全球死亡率最高的第三个国家。关于拉丁美洲住院死亡率及其风险因素的数据以及医院过度拥挤的影响尚未得到彻底探讨。在这项前瞻性队列研究中，我们招募了2020年2月26日至2020年6月5日在墨西哥城SARS-CoV-2转诊中心因确诊的严重COVID-19肺炎住院的连续成年患者。共有800例确诊患者入院，平均年龄为51.9 ± 13.9岁，61%为男性，85%为肥胖或超重，30%患有高血压，26%患有2型糖尿病。在这800例患者中，559例痊愈（69.9%），241例死亡（30.1%）。在幸存者中，101例（18%）接受有创机械通气（IMV），458例（82%）在重症监护室（ICU）外接受管理; ICU死亡率为49%。在非幸存者中，45.6%（n = 110）由于缺乏ICU床位而没有得到充分支持。在该亚组中，95%的病例的主要死亡原因是急性呼吸窘迫综合征（ARDS），而在接受完全支持的非幸存者（n = 105）中，主要死亡原因是脓毒性休克（45%），其次是ARDS（29%）。与院内死亡相关的主要危险因素为男性（RR 2.05，95%CI 1.34-3.12）、肥胖（RR 1.62，95%CI 1.14-2.32）-特别是病态肥胖（RR 3.38，95%CI 1.63-7.00）-和入院时血氧饱和度< 80%（RR 4.8，95%CI 3.26-7.31）。在这项研究中，我们发现与以前的报告相比，住院和ICU死亡率以及死亡率的危险因素相似。然而，45%没有存活的患者有理由进入ICU，但由于ICU床位不可用而没有接受IMV / ICU护理。此外，随着时间的推移，死亡率主要是由于ICU病床的可用性，间接表明过度拥挤是导致医院死亡率的主要因素之一。
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has remained in Latin America, Mexico has become the third country with the highest death rate worldwide. Data regarding in-hospital mortality and its risk factors, as well as the impact of hospital overcrowding in Latin America has not been thoroughly explored. In this prospective cohort study, we enrolled consecutive adult patients hospitalized with severe confirmed COVID-19 pneumonia at a SARS-CoV-2 referral center in Mexico City from February 26th, 2020, to June 5th, 2020. A total of 800 patients were admitted with confirmed diagnosis, mean age was 51.9 ± 13.9 years, 61% were males, 85% were either obese or overweight, 30% had hypertension and 26% type 2 diabetes. From those 800, 559 recovered (69.9%) and 241 died (30.1%). Among survivors, 101 (18%) received invasive mechanical ventilation (IMV) and 458 (82%) were managed outside the intensive care unit (ICU); mortality in the ICU was 49%. From the non-survivors, 45.6% (n = 110) did not receive full support due to lack of ICU bed availability. Within this subgroup the main cause of death was acute respiratory distress syndrome (ARDS) in 95% of the cases, whereas among the non-survivors who received full (n = 105) support the main cause of death was septic shock (45%) followed by ARDS (29%). The main risk factors associated with in-hospital death were male sex (RR 2.05, 95% CI 1.34–3.12), obesity (RR 1.62, 95% CI 1.14–2.32)—in particular morbid obesity (RR 3.38, 95%CI 1.63–7.00)—and oxygen saturation < 80% on admission (RR 4.8, 95%CI 3.26–7.31). In this study we found similar in-hospital and ICU mortality, as well as risk factors for mortality, compared to previous reports. However, 45% of the patients who did not survive justified admission to ICU but did not receive IMV / ICU care due to the unavailability of ICU beds. Furthermore, mortality rate over time was mainly due to the availability of ICU beds, indirectly suggesting that overcrowding was one of the main factors that contributed to hospital mortality.
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影响因子：
3.7
作者：
Rieg S;von Cube M;Kalbhenn J;Utzolino S;Pernice K;Bechet L;Baur J;Lang CN;Wagner D;Wolkewitz M;Kern WV;Biever P;COVID UKF Study Group
通讯作者：
COVID UKF Study Group
影响因子：
2.3
作者：
Basto-Abreu, Ana;Barrientos-Gutierrez, Tonatiuh;Villalpando, Salvador
通讯作者：
Villalpando, Salvador
DOI：
10.1164/rccm.201605-1081cp
发表时间：
2017-02-15
影响因子：
24.7
作者：
Brochard, Laurent;Slutsky, Arthur;Pesenti, Antonio
通讯作者：
Pesenti, Antonio
DOI：
10.1186/cc9975
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Cardoso LT;Grion CM;Matsuo T;Anami EH;Kauss IA;Seko L;Bonametti AM
通讯作者：
Bonametti AM
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
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