Risk factors for mortality in COVID-19 patients in a community teaching hospital
Risk factors for mortality in COVID-19 patients in a community teaching hospital
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DOI：
10.1002/jmv.26885
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发表时间：
2021-03-01
影响因子：
12.7
通讯作者：
Truong, James
中科院分区：
文献类型：
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作者：
Andrade, Justin A.;Muzykovsky, Karina;Truong, James
截至2020年12月，纽约市有超过450，000宗2019冠状病毒病（COVID-19）确诊病例，约25，000人死亡。既往文献确定高龄、疾病严重程度较高、炎症生物标志物升高、急性器官功能障碍、合并症和长期护理机构就诊是中国武汉和美国患者死亡的风险因素。在纽约市进行的其他研究有必要证实这些发现。本研究的目的是评估确诊COVID-19感染患者的住院死亡率的风险因素。这是一项在布鲁克林医院中心进行的回顾性病例对照研究，该医院是一家拥有464张床位的社区教学医院。纳入了确诊COVID-19感染并接受至少24小时COVID-19治疗的成人患者。进行单因素和多因素logistic回归分析，以确定院内死亡率的危险因素。共纳入284例患者，其中95例（33.5%）死亡，189例（66.5%）存活。多因素分析显示，高龄患者的住院死亡率较高（比值比[OR] 6.476; 95%置信区间[CI]，1.827-22.953），来自长期护理机构（OR 4.259; 95% CI 1.481-12.250），总胆红素升高（OR 4.947; 95% CI 1.048-23.350），开始血管加压药治疗（OR 36.262; 95% CI 5.319-247.216）和发生肾衰竭（OR 36.261; 95% CI 2.667-493.046）。社区教学医院中与COVID-19患者死亡率相关的风险因素包括高龄、血管加压药开始使用、肾衰竭发展、总胆红素升高和长期护理机构就诊。
As of December 2020, there were over 450,000 confirmed coronavirus disease 2019 (COVID-19) cases in New York City (NYC) with approximately 25,000 deaths. Previous literature identified advanced age, higher severity of illness, elevated inflammatory biomarkers, acute organ dysfunction, comorbidities, and presentation from long-term care facility as risk factors for mortality in patients from Wuhan, China, and the United States. Additional studies conducted in NYC are warranted to confirm these findings. The objective of this study was to assess the risk factors for in-hospital mortality in patients with confirmed COVID-19 infections. This was a retrospective case-control study at The Brooklyn Hospital Center, a 464-bed community teaching hospital. Adult patients with a confirmed COVID-19 infection and who received at least 24 h of COVID-19 therapy were included. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for in-hospital mortality. Two-hundred and eighty four patients were included, of whom 95 (33.5%) were nonsurvivors and 189 (66.5%) patients were survivors. Multivariate analysis showed higher in-hospital mortality with advanced age (odds ratio [OR] 6.476; 95% confidence interval [CI], 1.827-22.953), presentation from long-term care facility (OR 4.259; 95% CI 1.481-12.250), elevated total bilirubin (OR 4.947; 95% CI 1.048-23.350), vasopressor initiation (OR 36.262; 95% CI 5.319-247.216), and development of renal failure (OR 36.261; 95% CI 2.667-493.046). Risk factors associated with mortality for patients with COVID-19 in a community teaching hospital included advanced age, vasopressor initiation, development of renal failure, elevated total bilirubin, and presentation from long-term care facility.