Clinical and Demographic Characteristics on Admission and Their Prognostic Value at Discharge in 529 Consecutive COVID-19 Patients in Santiago, Chile
| Autor: | Patricia Cisternas, Diego Rojas Carvajal, Cesar Maquilon Ortiz, Cherie Gutierrez Rojas, Guillermo Garcia, Jose Gajardo, Nicolás Valdés, Lenny Loor Garcia, Jonas Alberto Gongora, Annelise Sepulveda, Cecilia Tapia, Ezio Parodi, Maria Carolina Asenjo, Monica Antolini Toledo, Javiera Huidobro Navarro, Luis Fernando Mallea, Juan Pablo Peralta, Felipe Rivera, Angela Benavente, Macarena Urra, Jyh Kae Nien, Maria Gabriela Bofill, Bernardita Alvarado Breton |
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| Rok vydání: | 2021 |
| Předmět: |
Mechanical ventilation
Creatinine medicine.medical_specialty business.industry medicine.medical_treatment Logistic regression Quality-adjusted life year chemistry.chemical_compound chemistry Interquartile range Internal medicine Cohort Mann–Whitney U test medicine General Earth and Planetary Sciences business General Environmental Science Cohort study |
| Zdroj: | Clinical Medicine Research. 10:1 |
| ISSN: | 2326-9049 |
| DOI: | 10.11648/j.cmr.20211001.11 |
| Popis: | On June 04, 2020, Chile had 113,628 cases COVID-19, 1275 deaths, 1450 patients were on invasive mechanical ventilation (IMV). The objective was describing the characteristics on admission and their relationship with the condition at discharge of patients with positive real-time polymerase chain reaction test for SARS CoV-2 (RT-PCR) in a tertiary health center. Methods: Retrospective and observational cohort study of 529 consecutive patients with positive RT-PCR for SARS CoV-2, discharged between March 14 and June 4, 2020 from Clinica Davila, Santiago. Demographic data, laboratory tests, Quality Adjusted Life Years (QALY), medical insurance, ventilatory assistance, and discharge condition were collected. Differences were evaluated by chi-square test, student’s t test, or Mann–Whitney U test. Logistic regression analysis was performed to identify variables that were predictive of condition at discharge. Results: A total of 529 patients were included (median age, 49 years [interquartile range {IQR}, 37-62; range, 0-97 years]; 45% women). The most common comorbidities were hypertension (171, 32.3%) and diabetes mellitus (98, 18.5%), On admission 352 patients (66.5%) had respiratory symptoms and 177 (33.4%) had other symptoms or other diagnoses. The median (IQR) PaO2 / FiO2 on admission of survivors, non-survivors and transferred were 316 (261-360), 167 (80-268) and 212 (130-261) respectively. At discharge, 448 (84.7%) were survivors, 54 (10.2%) non-survivors, and 27 (5.1%) were transferred to other centers. Median age of survivors and non-survivors was 46 (36-59) and 75.5 (66-84) years. Of the 116 patients (21,9%) who received support ventilation, 67 were discharged alive (57.8%), 28 died (24%), and 21 (18%) were transferred to another hospital. The variables associated with risk of death were: age ≥ 60 years (OR 15.3; 95% CI: 7.25–32.2; P = 0.001); QALY score ≤ 15 points (OR 14.01; 95% CI: 4.82 -40.67; P = 0.001); state health insurance (OR, 2.82; 95% CI: 1.38–5.77; P = 0.004); PaO2 / FiO2 on admission ≤ 200 (OR 5.2; 95% CI: 1.94-13.94; P = 0.001) and high sensitivity T Troponin ≥ 15 ng / L (OR 5.16; 95% CI: 1.95-13.64; P = 0.001). Conclusions: this cohort showed that on admission COVID-19 patients, the PaO2 / FiO2, creatinine and high sensitivity T troponin at the described cut-off points had prognostic value. At discharge, the non-survivors were the older, most often had state health insurance and their QALY scores were significantly lower. |
| Databáze: | OpenAIRE |
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