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[伊格纳西奥·查韦斯国家心脏病学研究所治疗的新冠肺炎病例的社会、人口统计学和病死特征。一项描述性横断面研究]

[Social, demographic and morbimortality characteristics of the cases treated for COVID-19 at the Ignacio Chávez National Institute of Cardiology. A descriptive cross-sectional study].

作者信息

Vallejo Maite, Gutiérrez-Esparza Guadalupe, Ríos-Núñez Lucía, Altamira-Mendoza Rosalinda, Groves-Miralrio Lucero E, Hernández-Lemus Enrique, Martínez-García Mireya

机构信息

Unidad de Investigación Sociomédica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

Cátedras CONACYT, Consejo Nacional de Ciencia y Tecnología, Ciudad de México, México.

出版信息

Arch Cardiol Mex. 2023 Sep 5;93(Supl 6):75-86. doi: 10.24875/ACM.22000095.

Abstract

INTRODUCTION

The COVID-19 pandemic brought with it a large number of adverse consequences for public health with serious socioeconomic repercussions. In this study we characterize the social, demographic, morbidity and mortality conditions of individuals treated for COVID-19 in one of the SARS-CoV-2 reference hospitals in Mexico City.

METHOD

A descriptive cross-sectional study was carried out in 259 patients discharged from the Instituto Nacional de Cardiología Ignacio Chávez, between April 11, 2020 and March 14, 2021. A multivariate logistic regression model was used to identify the association between sociodemographic and clinical variables. An optimization was performed using maximum likelihood calculations to choose the best model compatible with the data. The maximum likelihood model was evaluated using ROC curves, goodnessof-fit estimators, and multicollinearity analysis. Statistically significant patterns of comorbidities were inferred by evaluating a hypergeometric test over the frequencies of co-occurrence of pairs of conditions. A network analysis was implemented to determine connectivity patterns based on degree centrality, between comorbidities and outcome variables.

RESULTS

The main social disadvantages of the studied population are related to the lack of social security (96.5%) and the lag in housing conditions (81%). Variables associated with the probability of survival were being younger (p < 0.0001), having more durable material goods (p = 0.0034) and avoiding: pneumonia (p = 0.0072), septic shock (p < 0.0001) and acute respiratory failure (p < 0.0001); (AUROC: 91.5%). The comorbidity network for survival cases has a high degree of connectivity between conditions such as cardiac arrhythmias and essential arterial hypertension (Degree Centrality = 90 and 78, respectively).

CONCLUSIONS

Given that among the factors associated with survival to COVID-19 there are clinical, sociodemographic and social determinants of health variables, in addition to age; It is imperative to consider the various factors that may affect or modify the health status of a population, especially when addressing emerging epidemic phenomena such as the current COVID-19 pandemic.

摘要

引言

新冠疫情给公共卫生带来了大量不良后果,并产生了严重的社会经济影响。在本研究中,我们对墨西哥城一家新冠病毒参考医院中接受新冠治疗的患者的社会、人口、发病率和死亡率情况进行了描述。

方法

于2020年4月11日至2021年3月14日期间,对墨西哥国家心脏病学研究所伊格纳西奥·查韦斯分院出院的259名患者进行了描述性横断面研究。使用多元逻辑回归模型来确定社会人口统计学和临床变量之间的关联。通过最大似然计算进行优化,以选择与数据兼容的最佳模型。使用ROC曲线、拟合优度估计器和多重共线性分析对最大似然模型进行评估。通过对成对疾病共现频率进行超几何检验,推断出具有统计学意义的合并症模式。实施网络分析以基于度中心性确定合并症与结局变量之间的连通性模式。

结果

研究人群的主要社会劣势与缺乏社会保障(96.5%)和住房条件滞后(81%)有关。与生存概率相关的变量包括更年轻(p < 0.0001)、拥有更多耐用物资(p = 0.0034)以及避免出现:肺炎(p = 0.0072)、感染性休克(p < 0.0001)和急性呼吸衰竭(p < 0.0001);(曲线下面积:91.5%)。生存病例的合并症网络在诸如心律失常和原发性动脉高血压等疾病之间具有高度连通性(度中心性分别为90和78)。

结论

鉴于在与新冠病毒感染存活相关的因素中,除了年龄之外,还有临床、社会人口统计学和健康变量的社会决定因素;必须考虑可能影响或改变人群健康状况的各种因素,尤其是在应对当前新冠疫情等新出现的流行现象时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2477/12169363/40ef9ea48a2f/7974AX233-ACM-93-75-g001.jpg

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