بررسی یافته‌های اپیدمیولوژیک، بالینی و آزمایشگاهی بیماران مبتلا به کووید-19 بستری در بخش‌های مراقبت ویژه بیمارستان الزهرا (س)

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، مرکز تحقیقات بیهوشی و مراقبت‌های ویژه، مرکز تحقیقات عفونت‌های بیمارستانی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استاد، مرکز تحقیقات بیهوشی و مراقبت‌های ویژه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، مرکز تحقیقات عفونت‌های بیمارستانی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دکتری علم اطلاعات و دانش شناسی، بیمارستان الزهرا، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 پزشک عمومی، مرکز تحقیقات بیهوشی و مراقبت‌های ویژه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقاله پژوهشی




مقدمه: با توجه به بار بالای بیماری کووید-19 و فشاری که به سیستم بهداشت و درمان بخصوص در بخش مراقبت‌های ویژه وارد شد، بررسی متغیرهای پیش‌بینی‌کننده‌ی پیامد این بیماری می‌تواند در شناخت بهتر بیماران در معرض خطر و تخصیص مفیدتر منابع محدود، کمک‌کننده باشد.
روش‌ها: مبتلایان به کووید-19 بستری شده در بخش مراقبت ویژه مرکز پزشکی الزهرا(س) اصفهان در پاییز سال 1399، در یک مطالعه‌ی مشاهده‌ای بررسی شدند. یافته‌های دموگرافیک، علائم بالینی و آزمایشگاهی جهت یافتن عوامل مؤثر بر مرگ و میر بین دو گروه افراد فوت شده و بهبود یافته مقایسه شد.
یافته‌ها: 1144 بیمار مبتلا به کووید-19 بستری در بخش مراقبت ویژه در مطالعه بررسی شدند که 37/8 درصد از آنان فوت کردند. متغیرهای گلبول سفید (0/001 > P)، نوتروفیل (0/001 > P)، نسبت نوتروفیل به لنفوسیت (0/004 = P)، نیتروژن اوره خون (0/001 > P)، کراتینین (0/037 = P)، پروکلسی تونین (0/001 > P)، گلوکز (0/001 > P)، D-dimer (0/001 > P)، طول مدت بستری (0/001 > P) و اکسیژن درمانی (0/001 > P) ارتباط مستقیم با مرگ و میر داشتند و بیشترین نسبت شانس مربوط به نوتروفیل (3/59 = OR) بود. متغیرهای هموگلوبین (0/001 > P)، لنفوسیت (0/028 = P)، پلاکت (0/007 = P)، ائوزینوفیل (0/001 > P)، سدیم (0/001 > P)، پتاسیم (0/001 > P)، منیزیم (0/001 > P)، زمان پروترومبین (0/001 > P)، تعداد تنفس (0/022 > P) و علائم تنفسی (0/032 > P) ارتباط معکوس با فوت داشتند و کمترین نسبت شانس مربوط به منیزیم (0/01 = OR) بود.
نتیجه‌گیری: متغیرهای بالینی و آزمایشگاهی می‌توانند پیش‌بینی کننده‌ی پیامد بیماری در بیماران مبتلا به کووید-19 باشند و نقش به سزایی در مدیریت بهتر بیماران داشته باشند.

تازه های تحقیق

سعید عباسی: Google Scholar, PubMed

پرویز کاشفی: Google Scholar

سودابه رستمی: Google Scholar, PubMed

بهجت طاهری: Google Scholar

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Evaluation of Epidemiologic, Clinical and Laboratory Findings of COVID-19 Patients in Intensive Care Units, Alzahra Hospital

نویسندگان [English]

  • Saeed Abbasi 1
  • Parviz Kashefi 2
  • Soodabeh Rostami 3
  • Behjat Taheri 4
  • Atefeh Ghodsi 5
1 Professor, Anesthesiology and Critical Care Research Center, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 PHD in Information science and Epistemology, Alzahara Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
5 General Practitioner, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Considering the high burden of the COVID-19 disease and the pressure that was put on the health care system, especially in the intensive care unit (ICU), the examination of variables predicting the outcome of this disease can help in better understanding of patients at risk and more useful allocation of limited resources.
Methods: Patients with COVID-19 hospitalized in the ICU of Al-Zahra Medical Center were investigated in an observational (descriptive-analytical) study. Demographic, clinical, and laboratory findings were compared to find factors affecting mortality between two groups of deceased and survived patients. A comparison of demographic, clinical, and laboratory findings was conducted to identify factors influencing mortality rates in deceased and survived patients.
Findings: 1144 patients with COVID-19 were examined in the study, of which 674 were men (58.9%) and 470 were women (41.1%). The patients were split into two groups: 432 patients (37.8%) died, and 712 patients (62.2%) survived. The variables of white blood cells (P < 0.001), neutrophil (P < 0.001), neutrophil to lymphocyte ratio (P = 0.004), blood urea nitrogen (P < 0.001), creatinine (P = 0.037), procalcitonin (P < 0.001), D-dimer (P < 0.001), length of hospitalization (P < 0.001) and oxygen therapy (P < 0.001) were directly related with mortality and the highest odd ratio was related to neutrophil count (OR = 3.59). Variables of lymphocyte
(P = 0.028), eosinophil (P < 0.001), hemoglobin (P < 0.001), platelet (P = 0.007), sodium (P < 0.001), potassium (P < 0.001), magnesium (P < 0.001), prothrombin time (P < 0.001), respiratory rate group (P < 0.022) and respiratory symptom (P < 0.032) were inversely related to mortality and the lowest odd ratio was related to magnesium (OR = 0.01).
Conclusion: Examining clinical and laboratory characteristics helps us in better evaluation of patients, recognition of risk factors involved in the progression of the disease, and better management of patients.

کلیدواژه‌ها [English]

  • COVID-19
  • Mortality
  • Risk factors
  • Intensive care units

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مجله دانشکده پزشکی اصفهان
دوره 41، شماره 751
هفته 3، اسفند
بهمن و اسفند 1402
صفحه 1209-1218

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  • تاریخ دریافت: 14 آبان 1401
  • تاریخ پذیرش: 09 اردیبهشت 1403

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