土耳其某大流行医院非covid -19危重患者临床特征及死亡危险因素的回顾性横断面研究

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Malawi Medical Journal Pub Date : 2022-12-01 DOI:10.4314/mmj.v34i4.5
Banu Cevik, Burcu Kuzhan, Elif Bombacı, Kemal Tolga Saracoglu
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引用次数: 0

摘要

背景2019冠状病毒病(新冠肺炎)扰乱了标准的卫生政策和常规医疗护理,因此,许多临床疾病的管理和治疗途径发生了前所未有的变化。疫情的负面影响使系统性疾病更加复杂,并加速了死亡率。在过去的两年里,临床医生主要关注新冠肺炎患者;然而,非COVID-19危重患者需要从多个角度加以解决。本研究调查了与新冠肺炎疫情同时入院的非新冠肺炎重症监护患者的人口统计学和临床特征。本研究的目的是确定危重非COVID-19患者的死亡率风险因素。方法纳入2021年1月1日至2021年7月14日期间入住重症监护室(ICU)的所有连续病例。所有数据,包括年龄、性别、入院特征、患者依赖性、先前存在的系统性疾病、疾病严重程度(急性生理学和慢性健康评估-APACHE-II)、ICU预测死亡率,从医院的电子数据库中获得住院或入住ICU期间的维持生命的医疗程序、住院时间和入住ICU的时间。对所有患者的Charlson合并症指数(CCI)进行评估。结果在研究期间共筛查了192名患者。非手术患者、既往依赖患者、需要机械通气、持续肾脏替代治疗的患者以及需要输注血管活性药物的患者的死亡率显著增加。已有疾病的数量和入院时间对死亡率没有影响。非肿瘤患者的平均CCI显著高于APACHE II,但并不是死亡率的有力预测因素。结论在这项回顾性研究中,多变量分析证实,非肿瘤患者疾病的严重程度和对血管活性药物输注的需求显著高于危重非COVID-19患者的死亡率预测因素。
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The clinical characteristics and the risk factors for mortality in Non-COVID-19 critical patients in a pandemic hospital in Turkey: a retrospective cross-sectional study.

Background: Coronavirus disease 2019 (COVID-19) disrupted standard health policies and routine medical care, and thus, the management and treatment pathways of many clinical conditions have changed as never before. The negative impact of the pandemic rendered the systemic disease more complicated and accelerated mortality. For the last two years, clinicians have primarily focused on COVID-19 patients; however, the non-COVID-19 critically ill patients needed to be addressed from multiple perspectives. This study investigated the demographic and clinical characteristics of non-COVID-19 critical care patients admitted concurrently with a COVID-19 wave. The objective of this study was to identify the risk factors for mortality in critically ill non-COVID-19 patients.

Methods: All consecutive cases admitted to the intensive care unit (ICU) were included in the study between January 1, 2021 and July 14, 2021. All data, including age, gender, admission characteristics, patient dependency, pre-existing systemic diseases, the severity of illness (Acute Physiology and Chronic Health Evaluation -APACHE-II), predicted death rate in ICU, life-sustaining medical procedures on admission or during ICU stay, length of stay, and admission time to the ICU, were obtained from the hospital's electronic database. The Charlson Comorbidity Index (CCI) was assessed for all patients.

Results: A total of 192 patients were screened during the study period. Mortality was significantly increased in non-surgical patients, previously dependent patients, patients requiring mechanical ventilation, continuous renal replacement therapy, and patients requiring the infusion of vasoactive medications. The number of pre-existing diseases and the admission time had no impact on mortality. The mean CCI was significantly higher in non-survivors but was not a strong predictor of mortality as APACHE II.

Conclusions: In this retrospective study, the severity of illness and the need for vasoactive agent infusion were significantly higher in non-survivors confirmed by multivariate analysis as predictive factors for mortality in critical non-COVID-19 patients.

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来源期刊
Malawi Medical Journal
Malawi Medical Journal Medicine-General Medicine
CiteScore
1.50
自引率
0.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region. Topics covered in the journal include, but are not limited to: - Communicable diseases (HIV and AIDS, Malaria, TB, etc.) - Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.) - Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.) - Mental health - Environmental health - Nutrition - Health systems and health policy (Leadership, ethics, and governance) - Community systems strengthening research - Injury, trauma, and surgical disorders
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