Analysis of death risk factors of elderly patients with severe/critical COVID-19 infection pneumonia treated in emergency department
李文胜 1张静 1张如云 1薛玉 1雷轩 1刘岩1
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作者信息
1. 101149 北京,首都医科大学附属北京胸科医院急诊科
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摘要
目的 探讨经急诊收治的老年重症/危重症新冠肺炎患者死亡原因.方法 回顾性调查我院2022年12月15日至2023年1月15日期间经急诊收治的老年重症/危重症新冠肺炎患者,将67例患者分为好转组及死亡组,比较两组患者既往病史、合并症、临床表现、各项化验结果、治疗情况,应用SPSS 22.0 for windows软件进行单因素分析,计数资料采用卡方检验,计量资料符合正态分布者采用t检验,不符合正态分布者采用秩和检验.将单因素分析中,具有统计学意义的因素带入Logistic回归进行多因素分析,从而发现患者死亡的危险因素.结果 经急诊收治的老年重症/危重症新冠肺炎患者中,合并晚期肿瘤(P=0.039,OR=5.161,95％CI:1.089～24.465)、血清肌酐升高(P=0.045,OR=5.533,95％CI:1.039～29.682)、不能经口进食(P=0.002,OR=11.757,95％CI:2.544～54.345),具有统计学意义,且OR值＞1,是患者死亡的独立危险因素.结论 合并晚期肿瘤、血清肌酐升高、不能经口进食是经急诊收治的老年重症/危重症新冠感染肺炎患者死亡的独立危险因素.
Abstract
Objective To explore risk factors of death of elderly patients with severe/critical COVID-19 in-fection pneumonia who were admitted to the emergency department.Methods Retrospective investigation was conducted on the elderly patients with severe/critical COVID-19 infection who were admitted to our hospital from De-cember 15,2022 to January 15,2023.67 patients were divided into survival group and death group.The past medi-cal history,complications,clinical manifestations,various laboratory results,and treatment of the two groups were compared.Univariate analysis was conducted.Chi square test was used for counting data,and t test was used for measuring data that conform to the normal distribution,Rank sum test was used for those who do not follow a normal distribution.By incorporating statistically significant factors from univariate analysis into logistic regression for multi-variate analysis,we could identify risk factors for patient mortality.Results Among the elderly patients with severe/critical COVID-19 who were admitted to the emergency department,the P values of advanced tumors(P=0.039,OR=5.161,95％CI:1.089～24.465),elevated serum creatinine(P=0.045,OR=5.533,95％CI:1.039～29.682),and inability to eat orally(P=0.002,OR=11.757 95％CI:2.544～54.345)were less than 0.05,and they had statistically significant difference.The OR values of these were greater than 1,it means they were independ-ent risk factors for the death of the these patients.Conclusion The combination of advanced tumor,elevated serum creatinine,and inability to eat orally are independent risk factors for the death of elderly patients with severe/critical COVID-19 pneumonia admitted to the emergency department.
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