新型冠状病毒肺炎患者死亡原因的多因素logistic回归分析  

Risk factors of deaths in patients with COVID-19:a multivariate logistic regression analysis

作　　者：孙建华 贺行巍 陈成洋 王炎[1] 曾和松[1] SUN Jian-hua;HE Xing-wei;CHEN Cheng-yang;WANG Yan;ZENG He-song(Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;不详)

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]河北医科大学第一医院

出　　处：《内科急危重症杂志》2020年第5期364-368,共5页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨新型冠状病毒肺炎(COVID-19)患者死亡的相关危险因素。方法:回顾性分析COVID-19确诊患者939例的临床资料,根据患者的临床转归将其分为死亡组(110例)和生存组(829例),分析2组患者的临床特征、实验室及影像学检查以及治疗。采用单因素和多因素logistic回归模型分析COVID-19患者死亡的相关危险因素。结果:939例患者年龄62(51~70)岁,男性453例(48.2%),既往有吸烟史86例(9.2%),高血压病史348例(37.1%),糖尿病172例(18.3%),冠心病65例(6.9%),慢性阻塞性肺疾病(COPD)30例(3.2%),院内死亡110例(11.7%)。与生存组比较,死亡组患者年龄更大[68(61~76)岁vs 62(50~69)岁,P<0.001],男性比例更高(59.1%vs 40.9%,P<0.05)。死亡组患者既往有吸烟史,合并COPD、恶性肿瘤的比例明显高于生存组,差异有统计学意义(均P<0.05)。Logistic回归分析显示:血肌钙蛋白、白介素-6(IL-6)水平升高以及血氧饱和度和淋巴细胞计数的降低是患者死亡的独立危险因素。结论:血肌钙蛋白、血清IL-6水平升高以及血氧饱和度和淋巴细胞计数的降低是COVID-19患者院内死亡的独立危险因素。Objective:To explore the related-risk factors that affect the mortality in patients with COVID-19.Methods:The confirmed 939 cases of COVID-19 were retrospectively analyzed.According to clinical outcomes the patients were divided into two groups:the death(n=110)and survival groups(n=829).The clinical characteristics,laboratory tests,imaging tests and treatment of the patients in the two groups were compared.Univariate and multivariate logistic regression models were used to analyze the death-related risk factors of COVID-19 patients.Results:Out of 939 patients,median age of 62 years old(range:51~70 years old),453(48.2%)patients were men,there was previous smoking history in 86 cases(9.5%),hypertension in 348(37.1%),diabetes mellitus in 172(18.3%),coronary heart disease in 65(6.9%),and chronic obstructive pulmonary disease(COPD)in 30(3.2%).A total of 110 patients(11.7%)died in the hospital.As compared with the survival group,the patients in the death group were older[68(61-76)years old vs.62(50-69)years old,P<0.001],and the percentage of men was higher(59.1%vs 40.9%,P<0.05).The proportion of the smoking history,COPD and malignant tumors was significantly higher in the death group than that in the survival group(P<0.05).Logistic regression analysis showed that the increases in troponin and IL-6,as well as the decreases in blood oxygen saturation and lymphocyte count were independent risk factors for patients’death.Conclusions:Increased troponin and IL-6,and decreased blood oxygen saturation and lymphocyte count are independent risk factors for hospital-death of patients with COVID-19.

关 键 词：新型冠状病毒 肺炎 死亡原因 危险因素 

分 类 号：R563.14[医药卫生—呼吸系统]