Impact of high cardiovascular risk on hospital mortality in patients admitted to intensive care by COVID-19
| Autor: | Gláucia Maria Moraes de Oliveira, Jorge Henrique Paiter Nascimento, G P Dutra, Bruno Ferraz de Oliveira Gomes, João Luiz Fernandes Petriz, Basilio de Bragança Pereira, A S Azevedo, T M B Silva, D F P Pereira, P R Carmo Junior, L S Peres |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) business.industry Intensive care Emergency medicine Medicine In patient AcademicSubjects/MED00200 Hospital mortality Cardiology and Cardiovascular Medicine business Abstract Supplement Cardiac Care Unit (CCU) Intensive and Critical Cardiovascular Care |
| Zdroj: | European Heart Journal |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Background Some studies have shown a higher prevalence of deaths in patients with cardiovascular risk factors (CRF) during hospitalization for COVID-19. The impact of high cardiovascular risk on hospital mortality has not been evaluated. Methods Retrospective study with patients admitted to intensive care and confirmed diagnosis of COVID-19 by RT-PCR and with at least one measurement of troponin during hospitalization. The criteria for defining a high cardiovascular risk patient (HCR) were: history of established cardiovascular disease (myocardial infarction, stroke, or peripheral arterial disease), diabetes, chronic kidney disease with clearance 65 years). The population was divided into 4 groups according to the presence of HCR and elevated troponin. Mortality was assessed using the chi-square method, according to the number of CRF, and was assessed in the 4 predetermined groups through logistic regression adjusted for severity (using the SAPS3 score). Results After evaluating 271 admissions during the study period, 236 patients were included for analysis. The mean age was 61.14±16.2 years, with 63.1% men. The prevalence of hypertension was 55.5% and diabetes, 33.1%. 47.4% of the patients had HCR. There was a significant increase in mortality as the number of risk factors increased (no CRF: 5.9%; 1 CRF: 17.5%; 2 CRF: 32.2% and ≥3 CRF: 41.2%; p=0.001). In logistic regression, patients with high cardiovascular risk and high troponin had a higher incidence of hospital mortality (OR 40.38; 95% CI 11.78–138.39). Patients without high cardiovascular risk, but with high troponin also showed a significant association with the primary outcome (OR 16.7; 95% CI 4.45–62.74). In contrast, patients with high cardiovascular risk and normal troponin were not at higher risk of death (OR 2.06; 95% CI 0.56–7.56). Conclusion In patients admitted to intensive care by COVID-19, the high cardiovascular risk impacts on hospital mortality only in patients who presented an increase in troponin levels. Funding Acknowledgement Type of funding sources: None. |
| Databáze: | OpenAIRE |
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