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10.1016/j.medin.2020.09.002

http://scihub22266oqcxt.onion/10.1016/j.medin.2020.09.002
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33158594!7522623!33158594
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suck abstract from ncbi


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pmid33158594      Med+Intensiva+(Engl+Ed) 2021 ; 45 (1): 14-26
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  • Comparacion de las caracteristicas demograficas y comorbilidad de los pacientes con COVID-19 fallecidos en hospitales espanoles, en funcion de si ingresaron o no en Cuidados Intensivos #MMPMID33158594
  • Miro O; Alquezar-Arbe A; Llorens P; Martin-Sanchez FJ; Jimenez S; Martin A; Burillo-Putze G; Jacob J; Garcia-Lamberechts EJ; Pinera P; Del Castillo JG
  • Med Intensiva (Engl Ed) 2021[Jan]; 45 (1): 14-26 PMID33158594show ga
  • OBJECTIVE: To describe and compare the demographic characteristics and comorbidities of patients with COVID-19 who died in Spanish hospitals during the 2020 pandemic based on whether they were or were not admitted to an intensive care unit (ICU) prior to death. METHODS: We performed a secondary analysis of COVID-19 patients who died during hospitalization included by 62 Spanish emergency departments in the SIESTA cohort. We collected the demographic characteristics and comorbidities, determined both individually and estimated globally by the Charlson index (ChI). Independent factors related to ICU admission were identified and different analyses of sensitivity were performed to contrast the consistency of the findings of the principal analysis. RESULTS: We included the 338 patients from the SIESTA cohort that died during hospitalization. Of these, 77 (22.8%) were admitted to an ICU before dying. After multivariate adjustment, 3 out of the 20 basal characteristics analyzed in the present study were independently associated with ICU admission: dementia (no patients with dementia who died were admitted to the ICU: OR = 0, 95%CI = not calculable), active cancer (OR = 0.07; 95%CI = 0.02-0.21) and age (< 70 years: OR = 1, reference; 70-74 years: OR = 0.21; 95%CI = 0.08-0.54; 75-79 years: OR = 0.21; 95%CI = 0.08-0.54; >/= 80 years: OR = 0.02; 95%CI = 0.01-0.05). The probability of ICU admission significantly increased in parallel to the ChI, even after adjustment for age (ChI 0 points: OR = 0, reference; ChI 1 point: OR = 0.36; 95%CI = 0.16-0.83; ChI 2 points: OR = 0.36; 95%CI = 0.16-0.83; ChI >2 points: OR = 0.09; 95%CI = 0.04-0.23). The sensitivity analyses showed no gross differences compared to the principal analysis. CONCLUSIONS: The profile of COVID-19 patients who died without ICU admission is similar to that observed in the usual medical practice before the pandemic. The basal characteristics limiting their admission were age and global burden due to comorbidity, especially dementia and active cancer.
  • |*Hospital Mortality[MESH]
  • |*SARS-CoV-2[MESH]
  • |Age Distribution[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Analysis of Variance[MESH]
  • |Asthma/epidemiology[MESH]
  • |COVID-19/epidemiology/*mortality[MESH]
  • |Cohort Studies[MESH]
  • |Comorbidity[MESH]
  • |Confidence Intervals[MESH]
  • |Coronary Disease/epidemiology[MESH]
  • |Dementia/epidemiology[MESH]
  • |Diabetes Mellitus/epidemiology[MESH]
  • |Dyslipidemias/epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Hypertension/epidemiology[MESH]
  • |Intensive Care Units/*statistics & numerical data[MESH]
  • |Male[MESH]
  • |Neoplasms/epidemiology[MESH]
  • |Odds Ratio[MESH]
  • |Pandemics/*statistics & numerical data[MESH]
  • |Sex Distribution[MESH]
  • |Spain/epidemiology[MESH]


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