Mechanical ventilation for COVID-19: Outcomes following discharge from inpatient treatment.
Mechanical ventilation for COVID-19: Outcomes following discharge from inpatient treatment.
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DOI：
10.1371/journal.pone.0277498
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Yeh, Jackson
中科院分区：
文献类型：
--
作者：
Butler, Mark J. A.;Best, Jennie H.;Mohan, Shalini, V;Jonas, Jennifer A.;Arader, Lindsay;Yeh, Jackson
尽管机械通气（MV）用于治疗2019年严重冠状病毒病（COVID-19）患者，但对这种治疗的长期健康影响知之甚少。我们的目的是确定MV治疗COVID-19与再入院可能性、全因死亡率和再入院原因之间的关系。本研究是一项纵向观察设计，收集了2020年3月1日至2021年1月31日期间的电子健康记录（EHR）数据。参与者包括在此期间因COVID-19住院的17，652名患者，他们被随访至2021年6月30日。主要结局是出院后再次住院治疗。次要结局包括全因死亡率和再入院原因。使用考克斯比例风险回归模型比较了通气和非通气患者的再入院率和死亡率。采用多项logistic回归分析比较了不同MV状态再入院原因的差异。患者特征和疾病严重程度的测量在机械通气和未使用1：1倾向评分匹配的患者之间平衡。样本的中位年龄为63岁，女性占47.1%。有1，131例（6.4%）患者在首次住院期间需要MV。在倾向评分匹配样本中，需要MV的患者的再入院率（32.1%与9.9%）和风险更大[风险比（95%置信区间）= 3.34（2.72-4.10）]。全因死亡率（15.3% vs 3.4%）和风险[风险比（95%置信区间）= 3.12（2.32-4.20）]也与MV状态相关。与非通气患者相比，通气患者更有可能因COVID-19、传染病和呼吸诊断等原因再次入院。机械通气是重症患者的必要治疗手段。然而，它可能与不良结局相关，包括再次入院和死亡。更密集的出院后监测可能是必要的，以减少这种关联的发现。
Though mechanical ventilation (MV) is used to treat patients with severe coronavirus disease 2019 (COVID-19), little is known about the long-term health implications of this treatment. Our objective was to determine the association between MV for treatment of COVID-19 and likelihood of hospital readmission, all-cause mortality, and reason for readmission. This study was a longitudinal observational design with electronic health record (EHR) data collected between 3/1/2020 and 1/31/2021. Participants included 17,652 patients hospitalized for COVID-19 during this period who were followed through 6/30/2021. The primary outcome was readmission to inpatient care following discharge. Secondary outcomes included all-cause mortality and reason for readmission. Rates of readmission and mortality were compared between ventilated and non-ventilated patients using Cox proportional hazards regression models. Differences in reasons for readmission by MV status were compared using multinomial logistic regression. Patient characteristics and measures of illness severity were balanced between those who were mechanically ventilated and those who were not utilizing 1-to-1 propensity score matching. The sample had a median age of 63 and was 47.1% female. There were 1,131 (6.4%) patients who required MV during their initial hospitalization. Rates (32.1% versus 9.9%) and hazard of readmission were greater for patients requiring MV in the propensity score–matched samples [hazard ratio (95% confidence interval) = 3.34 (2.72–4.10)]. Rates (15.3% versus 3.4%) and hazard [hazard ratio (95% confidence interval) = 3.12 (2.32–4.20)] of all-cause mortality were also associated with MV status. Ventilated patients were more likely to be readmitted for reasons which were classified as COVID-19, infectious diseases, and respiratory diagnoses compared to non-ventilated patients. Mechanical ventilation is a necessary treatment for severely ill patients. However, it may be associated with adverse outcomes including hospital readmission and death. More intense post-discharge monitoring may be warranted to decrease this associational finding.
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影响因子：
3.7
作者：
Elsayed HH;Hassaballa AS;Ahmed TA;Gumaa M;Sharkawy HY;Moharram AA
通讯作者：
Moharram AA
影响因子：
8.8
作者：
Douglas, SL;Daly, BJ;Brennan, PF
通讯作者：
Brennan, PF
影响因子：
5.8
作者：
Berni, Andrea;Malandrino, Danilo;Peri, Alessandro
通讯作者：
Peri, Alessandro
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：
10.1016/j.cmi.2020.09.014
发表时间：
2021-01
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Bartoletti M;Marconi L;Scudeller L;Pancaldi L;Tedeschi S;Giannella M;Rinaldi M;Bussini L;Valentini I;Ferravante AF;Potalivo A;Marchionni E;Fornaro G;Pascale R;Pasquini Z;Puoti M;Merli M;Barchiesi F;Volpato F;Rubin A;Saracino A;Tonetti T;Gaibani P;Ranieri VM;Viale P;Cristini F;PREDICO Study Group
通讯作者：
PREDICO Study Group