Risk factors and interventions associated with mortality or survival in adult COVID-19 patients admitted to critical care: a systematic review and meta-analysis
| Autor: | Ross Hofmeyr, B M Biccard, A. Chen, E. Earle, JF Coetzee, T. Ndhlovu, E. H. Taylor, C. van Tonder, K. van der Spuy, M. Isaacs, C. Gerber, A. Usenbo, Alexandra Torborg, R. Boden, B. Mrara, K. F. Kabambi, M Nejthardt, Justiaan Swanevelder |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty business.industry Mortality rate medicine.medical_treatment Odds ratio 030204 cardiovascular system & hematology Intensive care unit Confidence interval law.invention 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine law Intensive care Meta-analysis Emergency medicine COVID-19 SARS-CoV-2 critical care outcomes mortality risk factors Extracorporeal membrane oxygenation Medicine 030212 general & internal medicine business |
| Zdroj: | Southern African Journal of Anaesthesia and Analgesia; Vol. 26 No. 3 (2020); 116-127 |
| ISSN: | 2220-1181 2220-1173 |
| Popis: | Background: Patients with confirmed COVID-19 admitted to intensive care units have a high mortality rate, which appears to be associated with increasing age, male sex, smoking history, hypertension and diabetes mellitus. Methods: A systematic review to determine risk factors and interventions associated with mortality/survival in adult patients admitted to an intensive care unit (ICU) with confirmed COVID-19/SARS-CoV-2 infection. The protocol was registered with PROSPERO (CRD42020181185). Results: The search identified 483 abstracts between 1 January and 7 April 2020, of which nine studies were included in the final review. Only one study was of low bias. Advanced age (odds ratio [OR] 11.99, 95% confidence interval [CI] 5.35–18.62) and a history of hypertension were associated with mortality (OR 4.17, 95% CI 2.90–5.99). Sex was not associated with mortality. There was insufficient data to assess the association between other comorbidities, laboratory results or critical care risk indices and mortality. The critical care interventions of mechanical ventilation (OR 6.25, 95% CI 0.75–51.93), prone positioning during ventilation (OR 2.06, 95% CI 0.20–21.72), and extracorporeal membrane oxygenation (ECMO) (OR 8.00, 95% CI 0.69, 92.33) were not associated with mortality. The sample size was insufficient to conclusively determine the association between these interventions and ICU mortality. The need for inotropes or vasopressors was associated with mortality (OR 6.36, 95% CI 1.89–21.36). Conclusion: The studies provided little granular data to inform risk stratification or prognostication of patients requiring intensive care admission. Larger collaborative research is needed to address this limitation. The full article is available at https://doi.org/10.36303/SAJAA.2020.26.3.2428 |
| Databáze: | OpenAIRE |
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