医院内COVID-19死亡率预测因素的重要性在一个月内发生变化
Tanya Mohammadi1, Mehdi Rezaee2, Seyed Mehdi Shahnematollahi3
1School of Mathematics, Statistics, and Computer Science, College of Science, University of Tehran, Tehran, Iran.
Journal of the National Medical Association
|September 2, 2023
概括
随着时间的推移,COVID-19死亡率的预测因素发生了变化. 器官功能障碍和年龄在早期至关重要,而热素水平在住院后期变得更加重要,用于预测死亡.
科学领域:
- 医学研究 医学研究
- 传染病流行病学 传染病流行病学
- 临床预测建模临床预测建模
背景情况:
- 有效的风险分层对于管理COVID-19患者至关重要.
- 了解死亡率预测因素在住院期间如何演变是必不可少的.
研究的目的:
- 在28天的时间内调查COVID-19住院患者死亡预测指标的重要性的动态变化.
- 在住院的不同阶段确定影响死亡风险的关键因素.
主要方法:
- 来自纽约四家医院的4370名住院COVID-19病例的二次分析.
- 患者根据住院时间分为三组:第1天,第2-7天和第8-28天.
- 主要组件分析用于评估12个死亡预测指标的重要性变化.
主要成果:
- 早期预测因素 (1日) 包括器官功能障碍和血清阿斯巴酸胺转移酶和的升高,特别是在老年患者中. 正常的热素表明死亡风险较低.
- 随着时间的推移,高酸阿米诺转移酶和的含量显著下降.
- 升高的热波宁水平成为医院住院后死亡率的更为关键的预测因素.
- 高血清肌素和C-反应蛋白总是预测出差的结果.
- 年龄和死亡风险之间的关联随着住院时间的延长而增加.
- 建议在管理的早期保持正常的血压.
结论:
- 某些患者特征对COVID-19死亡率的预测重要性随着住院时间的长短而有很大变化.
- 这些动态变化必须纳入预测模型和COVID-19患者的临床管理策略.
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