因 COVID-19 相关肺炎住院的老年患者院内和 1 年死亡率的风险因素。

IF 2.4 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Experimental and therapeutic medicine Pub Date : 2023-11-20 DOI:10.3892/etm.2023.12310
Vasiliki Epameinondas Georgakopoulou, Aikaterini Gkoufa, Sotiria Makrodimitri, Aristeidis Tsakanikas, Dimitrios Basoulis, Pantazis M Voutsinas, Georgios Karamanakos, Irene Eliadi, Stamatia Samara, Maria Triantafyllou, Ioanna Eleftheriadou, Olga Kampouropoulou, Chrysovalantis V Papageorgiou, Amalia Anastasopoulou, Petros Papalexis, Ilias Trakas, Nikolaos Trakas, Demetrios A Spandidos, Paschalis Steiropoulos, Nikolaos V Sipsas
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引用次数: 0

摘要

冠状病毒病 2019(COVID-19)的特点是疗效差、死亡率高,尤其是老年患者。自这一流行病开始流行以来,人们就认识到,年龄越大是疾病严重程度的关键风险因素,每十年的死亡率都在增加。这种现象可能是以往健康状况较差、原有合并症较多、体弱程度较高的结果。关于老年患者的预后和风险因素的大多数研究都是针对第一波大流行以及这些患者院内死亡率的预测因素。本研究旨在详细描述大流行各阶段因 COVID-19 相关肺炎住院的老年患者(年龄≥65 岁)的临床特征和管理情况,介绍他们的治疗结果,并对这一特别易感人群一年内的院内和院外死亡率预测因素进行调查。研究共纳入了 1124 名老年患者(603 名男性,占 53.7%),他们的平均年龄为 78.51±7.42 岁,夏尔森综合症指数(CCI)中位数为 5。在这些患者中,104 人(9.3%)在武汉原株流行期间住院,385 人(34.3%)在阿尔法变异株流行期间住院,221 人(19.7%)在德尔塔变异株流行期间住院,414 人(36.8%)在奥米克隆变异株流行期间住院。总体而言,院内死亡率为 33.4%(375 名患者),1 年死亡率为 44.7%(502 名患者)。考虑到感染时间,大多数患者未接种或未完成严重急性呼吸系统综合征冠状病毒-2的全面接种(843名患者,75%)。年龄、未成熟粒细胞、乳酸脱氢酶(LDH)水平、铁蛋白水平、胸部 X 光片评分以及未接种全部疫苗、咳嗽和疲劳与院内死亡率在统计学上有显著的独立相关性,而年龄、LDH 水平、铁蛋白水平、丙氨酸氨基转移酶水平、CCI、胸部 X 光片评分、未咳嗽和疲劳以及痴呆病史与 1 年死亡率在统计学上有显著的独立相关性。总体而言,本研究表明,因 COVID-19 相关肺炎住院的老年患者的院内死亡率和 1 年死亡率都很高。
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Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia.
Coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and a high mortality rate, particularly among elderly patients. Since the beginning of the pandemic, an older age has been recognized as a critical risk factor for disease severity, with increasing mortality rates in each decade of life. This phenomenon may be a consequence of a poor previous health status, with a higher prevalence of pre-existing comorbidities and a higher degree of frailty. The majority of studies on the outcomes and risk factors of elderly patients refer to the first waves of the pandemic and the predictors of in-hospital mortality in these patients. The aim of the present study was to provide a detailed description of the clinical characteristics and management of a cohort of elderly patients (≥65 years of age) who were hospitalized with COVID-19-related pneumonia in all phases of the pandemic, presenting their outcomes, and investigating predictors of in-hospital and out-of-hospital mortality over a period of 1 year in this particularly vulnerable population. A total of 1,124 elderly patients (603 males, 53.7%) with a mean age of 78.51±7.42 years and a median Charlson comorbidity index (CCI) of 5 were included in the study. Of these patients, 104 (9.3%) were hospitalized during the period of prevalence of the original strain Wuhan, 385 (34.3%) were hospitalized during the period of prevalence of the Alpha variant, 221 (19.7%) were hospitalized during the period of prevalence of the Delta variant, and 414 (36.8%) were hospitalized during the period of prevalence of the Omicron variant. Overall, the in-hospital mortality rate was 33.4% (375 patients), and the 1-year mortality rate was 44.7% (502 patients). The majority of patients had not been vaccinated or had not completed full vaccination against severe acute respiratory syndrome coronavirus-2 (843 patients, 75%), given the period of infection. Age, immature granulocytes, lactate dehydrogenase (LDH) levels, ferritin levels, chest X-ray score, as well as the absence of full vaccination, cough and fatigue, were statistically significantly and independently associated with in-hospital mortality, while age, LDH levels, ferritin levels, alanine aminotransferase levels, CCI, chest X-ray score, the absence of cough and fatigue, and a history of dementia were statistically significantly and independently associated with 1-year mortality. On the whole, the present study demonstrates that both the in-hospital mortality and 1-year mortality rates of elderly patients hospitalized due to COVID-19-related pneumonia are high.
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Experimental and therapeutic medicine
Experimental and therapeutic medicine MEDICINE, RESEARCH & EXPERIMENTAL-
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