Risk factors for mortality in critically ill patients with COVID-19 in Huanggang, China: A single-center multivariate pattern analysis

被引:12
作者
Chen, Yinyin [1 ,2 ,3 ,4 ]
Linli, Zeqiang [5 ,6 ]
Lei, Yuting [1 ,2 ]
Yang, Yiya [1 ,2 ,3 ,4 ]
Liu, Zhipeng [7 ]
Xia, Youchun [7 ]
Liang, Yumei [1 ,2 ,3 ,4 ]
Zhu, Huabo [1 ,2 ]
Guo, Shuixia [5 ,6 ]
机构
[1] Hunan Normal Univ, Hunan Prov Peoples Hosp, Dept Nephrol, Changsha, Peoples R China
[2] Hunan Normal Univ, Hunan Prov Peoples Hosp, Lab Kidney Dis, Changsha, Peoples R China
[3] Changsha Clin Res Ctr Kidney Dis, Changsha, Peoples R China
[4] Hunan Clin Res Ctr Chron Kidney Dis, Changsha, Peoples R China
[5] Hunan Normal Univ, Sch Math & Stat, MOE LCSM, Changsha, Peoples R China
[6] Hunan Normal Univ, Coll Hunan Prov, Key Lab Appl Stat & Data Sci, Changsha, Peoples R China
[7] Dabie Mt Reg Med Ctr, Huanggang, Peoples R China
基金
中国国家自然科学基金;
关键词
clinical indicators; COVID-19; machine learning; risk factor; self-evaluation; CLINICAL CHARACTERISTICS; VIRUS;
D O I
10.1002/jmv.26572
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
To date, the coronavirus disease 2019 (COVID-19) has a worldwide distribution. Risk factors for mortality in critically ill patients, especially detailed self-evaluation indicators and laboratory-examination indicators, have not been well described. In this paper, a total of 192 critically ill patients (142 were discharged and 50 died in the hospital) with COVID-19 were included. Self-evaluation indicators including demographics, baseline characteristics, and symptoms and detailed lab-examination indicators were extracted. Data were first compared between survivors and nonsurvivors. Multivariate pattern analysis (MVPA) was performed to identify possible risk factors for mortality of COVID-19 patients. MVPA achieved a relatively high classification accuracy of 93% when using both self-evaluation indicators and laboratory-examination indicators. Several self-evaluation factors related to COVID-19 were highly associated with mortality, including age, duration (time from illness onset to admission), and the Barthel index (BI) score. When the duration, age increased by 1 day, 1 year, BI decreased by 1 point, the mortality increased by 3.6%, 2.4%, and 0.9% respectively. Laboratory-examination indicators including C-reactive protein, white blood cell count, platelet count, fibrin degradation products, oxygenation index, lymphocyte count, andd-dimer were also risk factors. Among them, duration was the strongest predictor of all-cause mortality. Several self-evaluation indicators that can simply be obtained by questionnaires and without clinical examination were the risk factors of all-cause mortality in critically ill COVID-19 patients. The prediction model can be used by individuals to improve health awareness, and by clinicians to identify high-risk individuals.
引用
收藏
页码:2046 / 2055
页数:10
相关论文
共 28 条
[1]   Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome [J].
Arabi, Yaseen M. ;
Mandourah, Yasser ;
Al-Hameed, Fahad ;
Sindi, Anees A. ;
Almekhlafi, Ghaleb A. ;
Hussein, Mohamed A. ;
Jose, Jesna ;
Pinto, Ruxandra ;
Al-Omari, Awad ;
Kharaba, Ayman ;
Almotairi, Abdullah ;
Al Khatib, Kasim ;
Alraddadi, Basem ;
Shalhoub, Sarah ;
Abdulmomen, Ahmed ;
Qushmaq, Ismael ;
Mady, Ahmed ;
Solaiman, Othman ;
Al-Aithan, Abdulsalam M. ;
Al-Raddadi, Rajaa ;
Ragab, Ahmed ;
Balkhy, Hanan H. ;
Al Harthy, Abdulrahman ;
Deeb, Ahmad M. ;
Al Mutairi, Hanan ;
Al-Dawood, Abdulaziz ;
Merson, Laura ;
Hayden, Frederick G. ;
Fowler, Robert A. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2018, 197 (06) :757-767
[2]  
Dhama K, 2020, CLIN MICROBIOL REV, V33, DOI [10.1128/CMR.00028-20, 10.1038/s41432-020-0088-4]
[3]   Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy Early Experience and Forecast During an Emergency Response [J].
Grasselli, Giacomo ;
Pesenti, Antonio ;
Cecconi, Maurizio .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1545-1546
[4]  
Guan WJ, 2020, NEW ENGL J MED, V382, P1861, DOI 10.1056/NEJMc2005203
[5]  
Italian National Institute of Health, REP COVID 19 PAT
[6]   Corticosteroids as adjunctive therapy in the treatment of influenza [J].
Lansbury, Louise ;
Rodrigo, Chamira ;
Leonardi-Bee, Jo ;
Nguyen-Van-Tam, Jonathan ;
Lim, Wei Shen .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2019, (02)
[7]   Pharmacological agents for adults with acute respiratory distress syndrome [J].
Lewis, Sharon R. ;
Pritchard, Michael W. ;
Thomas, Carmel M. ;
Smith, Andrew F. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2019, (07)
[8]   Prevalence of Hospital-Associated Disability in Older Adults: A Meta-analysis [J].
Loyd, Christine ;
Markland, Alayne D. ;
Zhang, Yue ;
Fowler, Mackenzie ;
Harper, Sara ;
Wright, Nicole C. ;
Carter, Christy S. ;
Buford, Thomas W. ;
Smith, Catherine H. ;
Kennedy, Richard ;
Brown, Cynthia J. .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2020, 21 (04) :455-+
[9]   Do specific virus-bacteria pairings drive clinical outcomes of pneumonia? [J].
McCullers, J. A. .
CLINICAL MICROBIOLOGY AND INFECTION, 2013, 19 (02) :113-118
[10]  
Mebane WR Jr, 2011, J STAT SOFTW, V42, P1