滨海边疆区covid -19相关死亡分析

V. Ivanis, A. Popov
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摘要

目标。评估与covid -19相关的致死结果的因素,并确定住院医疗质量方面的差距。材料和方法。随机抽取滨海边疆区各医院2020年6月至2021年8月期间116例covid -19相关致死病例的病史,对专家意见(医疗质量报告)进行分析。死亡率最高的是60 ~ 79岁(53.4%)和80 ~ 96岁(30.2%)。致死结果平均发生在发病后12.8±1.3天。96.5%的死者伴有各种器官和系统的慢性病变,其中大多数患者有三个或更多身体系统的合并症(55.2%)。9例(7.8%)临床与病理诊断不一致,与临床诊断结构及并发症重估有关。84.5%的患者直接死亡原因为急性呼吸窘迫综合征。患有合并症的老年人和老年患者发生严重和致命COVID-19后果的风险最高。管理这类患者的困难与诊断的复杂性、危重情况的解释和适当治疗的选择有关。
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An analysis of COVID-19-associated deaths in Primorsky Krai
Objective. To assess factors in COVID-19-associated lethal outcomes and to identify gaps in the quality of inpatient medical care.Materials and methods. An analysis of expert opinions (reports of medical care quality) was carried out using a random sample of 116 medical histories of COVID-19-associated lethal outcomes from various hospitals in Primorsky Krai for the period from June 2020 to August 2021.Results. The highest mortality was observed among patients aged 60–79 (53.4%) and 80–96 (30.2%). The lethal outcome occurred, on average, on the 12.8 ± 1.3 day of illness. Concomitant chronic pathologies of various organs and systems was observed in 96.5% of the deceased, with the majority of such patients having had comorbidities of three or more body systems (55.2%). Discrepancies in clinical and pathoanatomic diagnoses were noted in nine cases (7.8%) and were related to the structure of the clinical diagnosis and the reassessment of COVID-19 complications. The immediate cause of death in 84.5% of patients was acute respiratory distress syndrome.Conclusion. Elderly and senile patients with comorbid diseases are at highest risk of severe and lethal COVID-19 outcome. The difficulty of managing such patients is associated with the complexity of diagnosis, interpretation of critical conditions, and selection of appropriate therapy.
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