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在重症监护室住院的COVID-19患者中,器官功能障碍的时间模式:基于小组的多轨迹建模分析
Jiafei Yu1, Kai Zhang2, Tianqi Chen3
1Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; Department of Critical Care Medicine, Haiyan People's Hospital, Zhejiang 314300, China.
概括
分析了重症监护室入院的COVID-19患者的器官功能障碍 (OD) 轨迹. 确定了四种不同的模式,呼吸功能障碍预测了预后和非肺性OD.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 2019年新冠病毒疾病 (COVID-19) 患者器官功能障碍 (OD) 的进展情况尚不清楚.
- 这项研究调查了入住重症监护室 (ICU) 的重症COVID-19患者的OD时间模式.
研究的目的:
- 分析ICU住院COVID-19患者器官功能障碍 (OD) 的时间轨迹.
- 识别OD进展的不同模式及其与患者结果的关联.
主要方法:
- 连续器官衰竭评估 (SOFA) 评分每天被评估,直到入院后的两周.
- 基于组的多轨迹建模 (GBMTM) 用于确定时间OD模式.
- 分析了每个已识别的轨迹的APACHE II分数和28天死亡率.
主要成果:
- 总共有392名COVID-19患者被分析,28天死亡率为53.6%.
- GBMTM确定了四种不同的OD轨迹:轻度 (n=64),中度 (n=140),重度 (n=117) 和极度重度 (n=71).
- 死亡率在不同轨迹上有很大差异,从轻度OD的低水平到极度严重OD的97.2%,有器官系统参与和进展的明显模式.
结论:
- 在接受ICU治疗的COVID-19患者中发现了四种不同的器官功能障碍轨迹.
- 呼吸功能障碍的轨迹可以预测非肺性OD模式和患者整体预后.
- 了解这些轨迹可以有助于危险分层和危重病的COVID-19患者的管理.
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