Mortality Risk in Patients with Severe COVID-19 Pneumonia in ICU at Nakhonpathom Hospital: A Prospective Cohort Study
Keywords:
severe COVID-19 pneumonia, ICU, mortalityAbstract
Background: Coronavirus disease 2019 (COVID-19) has spread around the world. The mortality rate of COVID-19 patients with mechanical ventilation is 49–60%. Therefore, the determination of risk factors for mortality is an important practical point.
Objective: To investigate factors associated with the mortality in patients with severe COVID-19 pneumonia in an intensive care unit (ICU) at Nakhonpathom Hospital
Methods: A prospective cohort study was conducted from 1 May 2021 to 31 December 2021. Patients aged 18 years or older hospitalized with COVID-19 pneumonia were included. For the multivariate analysis, Poisson regression statistics were applied to estimate the adjusted risk ratio.
Results: A total of 176 patients were included. The mortality rate was 55.1%. Common causes of death were hospital acquired infection (44.3%) and respiratory failure (40.2%). Associated factors for the mortality were age >60 years, (ARR 1.63, p = 0.002), non-vaccination against COVID-19 and receiving only one dose of vaccination (ARR 5.16, p=0.002 and ARR 3.40, p = 0.028, respectively), partially dependent functional status (ARR 2.03, p = 0.008), requiring intubation with mechanical ventilation (ARR 4.01, p = 0.030), acute respiratory distress syndrome (ARDS) (ARR 1.49, p = 0.009), sudden cardiac arrest (ARR 1.64, p = 0.016), and pneumothorax (ARR 2.99, p = 0.034).
Conclusion: The mortality rate of patients with severe COVID-19 pneumonia is comparable to international studies. Significant factors associated with mortality include age 60 years or older, not being vaccinated against COVID-19 or only one dose of vaccination, poor functional status, invasive mechanical ventilation, ARDS, sudden cardiac arrest, and pneumothorax
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กองโรคไม่ติดต่อ. รายงานผลการทบทวนสถานการณ์โรคโควิด-19 และมาตรการควบคุมป้องกันในระดับโรค และในประเทศไทย. 2564. [เข้าถึงเมื่อ 1 มีนาคม 2564 ]. เข้าถึงได้จาก: http://www.thaincd.com/ document/file/download/knowledge/COVID19.65.pdf
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