tetano
Editor, Senior Moderator
Cureus
. 2022 May 26;14(5):e25374.
doi: 10.7759/cureus.25374. eCollection 2022 May.
Prognostic Factors Associated With Mortality of Patients With COVID-19 Requiring Ventilator Management: A Retrospective Cohort Study
Masaatsu Kuwahara[SUP] 1 [/SUP], Misa Kamigaito[SUP] 1 [/SUP], Hiromoto Murakami[SUP] 1 [/SUP], Kiyoko Sato[SUP] 1 [/SUP], Naomi Mambo[SUP] 1 [/SUP], Tomoyuki Kobayashi[SUP] 1 [/SUP], Kunihiro Shirai[SUP] 1 [/SUP], Atsushi Miyawaki[SUP] 1 [/SUP], Munehiko Ohya[SUP] 1 [/SUP], Jun-Ichi Hirata[SUP] 1 [/SUP]
Affiliations
Abstract
Aim There are few reports on the prognostic factors associated with mortality in coronavirus disease (COVID-19) patients with critical disease. This study assessed prognostic factors associated with mortality of patients with critical COVID-19 who required ventilator management. Methods This single-center, retrospective cohort study used medical record data of COVID-19 patients admitted to an emergency ICU at a hospital in Japan between March 1, 2020 and September 30, 2021, and provided with ventilator management. Multivariable logistic regression was used to identify factors associated with mortality. Results Seventy patients were included, of whom 29 (41.4%) died. The patients who died were significantly older (median: 69 years) (interquartile range [IQR]: 47-82 years) than the patients who survived (62 years [38-84 years], p<0.007). In addition, patients who died were significantly less likely to have received steroid therapy than patients who survived (25 [86.2%] vs. 41 [100%], p=0.026). In the multivariable analysis, age was identified as a significant prognostic factor for mortality and the risk of death increased by 6% for every one-year increase in age (OR: 1.06; 95% CI: 1.00-1.13; p=0.048). Medical history was not a risk factor for death. Conclusion Age was a predictor of mortality in critically ill patients with COVID-19. Therefore, the indications for critical care in older patients with COVID-19 should be carefully considered.
Keywords: covid-19; critical care outcomes; mortality; older-aged patients; prognostic factor.
. 2022 May 26;14(5):e25374.
doi: 10.7759/cureus.25374. eCollection 2022 May.
Prognostic Factors Associated With Mortality of Patients With COVID-19 Requiring Ventilator Management: A Retrospective Cohort Study
Masaatsu Kuwahara[SUP] 1 [/SUP], Misa Kamigaito[SUP] 1 [/SUP], Hiromoto Murakami[SUP] 1 [/SUP], Kiyoko Sato[SUP] 1 [/SUP], Naomi Mambo[SUP] 1 [/SUP], Tomoyuki Kobayashi[SUP] 1 [/SUP], Kunihiro Shirai[SUP] 1 [/SUP], Atsushi Miyawaki[SUP] 1 [/SUP], Munehiko Ohya[SUP] 1 [/SUP], Jun-Ichi Hirata[SUP] 1 [/SUP]
Affiliations
- PMID: 35774696
- PMCID: PMC9236674
- DOI: 10.7759/cureus.25374
Abstract
Aim There are few reports on the prognostic factors associated with mortality in coronavirus disease (COVID-19) patients with critical disease. This study assessed prognostic factors associated with mortality of patients with critical COVID-19 who required ventilator management. Methods This single-center, retrospective cohort study used medical record data of COVID-19 patients admitted to an emergency ICU at a hospital in Japan between March 1, 2020 and September 30, 2021, and provided with ventilator management. Multivariable logistic regression was used to identify factors associated with mortality. Results Seventy patients were included, of whom 29 (41.4%) died. The patients who died were significantly older (median: 69 years) (interquartile range [IQR]: 47-82 years) than the patients who survived (62 years [38-84 years], p<0.007). In addition, patients who died were significantly less likely to have received steroid therapy than patients who survived (25 [86.2%] vs. 41 [100%], p=0.026). In the multivariable analysis, age was identified as a significant prognostic factor for mortality and the risk of death increased by 6% for every one-year increase in age (OR: 1.06; 95% CI: 1.00-1.13; p=0.048). Medical history was not a risk factor for death. Conclusion Age was a predictor of mortality in critically ill patients with COVID-19. Therefore, the indications for critical care in older patients with COVID-19 should be carefully considered.
Keywords: covid-19; critical care outcomes; mortality; older-aged patients; prognostic factor.