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成人 COVID-19 患者死亡的危险因素:虚弱预示着老年患者的致命结局。

Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients.

机构信息

Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Division of Internal Medicine and Infectious Diseases, Stockholm, SE-18288 Sweden.

Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Division of Internal Medicine and Infectious Diseases, Stockholm, SE-18288 Sweden.

出版信息

Int J Infect Dis. 2021 Jan;102:415-421. doi: 10.1016/j.ijid.2020.10.071. Epub 2020 Oct 30.

Abstract

OBJECTIVES

This study investigated demographics, comorbidities, and death rate in hospitalized patients with confirmed COVID-19. In addition, we hypothesized that functional status, according to the Clinical Frailty Scale (CFS), in patients aged 65 years or older is a better predictor of poor outcome than age and comorbidities.

METHODS

A total of 255 randomly selected COVID-19 patients admitted to a university hospital were included and followed up for 60 days. Patient data were extracted manually from the electronic health records with use of a standardized protocol.

RESULTS

The age of the study population ranged between 20 and 103 years (mean age 66 years ± 17 years). Hypertension, diabetes mellitus, and obesity were the three most prevalent comorbidities. At the 60-day follow-up, 70 patients (27%) had died. In multivariate analyses, age, chronic kidney disease, and previous stroke were associated with death. Most fatal cases (90%) occurred in patients aged 65 years or older. Among such patients, CFS level was the only predictor of death in multivariate analyses.

CONCLUSIONS

This study shows that increasing age, chronic kidney disease, and previous stroke significantly contribute to a fatal outcome in hospitalized patients with COVID-19. In patients aged 65 years or older, CFS level was the strongest prognostic factor for death.

摘要

目的

本研究调查了确诊 COVID-19 住院患者的人口统计学特征、合并症和死亡率。此外,我们假设根据临床虚弱量表(CFS),年龄在 65 岁或以上的患者的功能状态是比年龄和合并症更好的不良预后预测指标。

方法

共纳入 255 名随机选择的 COVID-19 住院患者,并进行了 60 天的随访。使用标准化协议从电子健康记录中手动提取患者数据。

结果

研究人群的年龄在 20 岁至 103 岁之间(平均年龄 66 岁±17 岁)。高血压、糖尿病和肥胖是最常见的三种合并症。在 60 天的随访中,70 名患者(27%)死亡。多变量分析显示,年龄、慢性肾脏病和既往卒中与死亡相关。大多数死亡病例(90%)发生在年龄在 65 岁或以上的患者中。在这些患者中,CFS 水平是多变量分析中死亡的唯一预测因素。

结论

本研究表明,年龄增加、慢性肾脏病和既往卒中显著增加 COVID-19 住院患者的致命结局。在年龄在 65 岁或以上的患者中,CFS 水平是死亡的最强预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/534d/7833745/1f85d2dd3617/gr1_lrg.jpg

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