244例新型冠状病毒肺炎患者的死亡危险因素分析

Analysis of risk factors for death in 244 COVID-19 patients

目的探讨新型冠状病毒肺炎(COVID-19)患者死亡危险因素。方法收集244例COVID-19患者的病案信息,根据病人的结局情况分为存活组(226例)与死亡组(18例),比较两组的临床资料并且分析死亡危险因素。结果与存活组相比,死亡组年龄更大;呼吸困难患者更多;住院时间更短;中性粒细胞计数和中性粒细胞-淋巴细胞比值、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、肌酐、尿素水平明显增高,活化部分凝血活酶时间延长;淋巴细胞计数、嗜酸性粒细胞、氧合指数、白蛋白水平明显降低。Logistic回归分析显示,CRP、LDH、白蛋白水平是预测COVID-19患者死亡的独立危险因素。结论CRP和LDH的升高以及低白蛋白水平对预测疾病不良结局具有重要的意义,应加强监测以改善疾病预后降低其死亡率。

Objective To explore the risk factors of death in patients with Corona Virus Disease 2019(COVID-19).Methods Medical records of 244 patients with COVID-19 were collected and divided into survival group(226 cases)and death group(18 cases)according to the outcome of the patients.The clinical data of the two groups were compared and the risk factors of death were analyzed.Results Compared with the survival group,the death group was older.More patients with dyspnea.The length of hospital stay was shorter.Neutrophil count,neutrophil lymphocyte ratio,C-reactive protein(CRP),lactate dehydrogenase(LDH),creatinine and urea levels were significantly increased,and activated partial thromboplastin time was prolonged.Lymphocyte count,eosinophil,oxygenation index and albumin level were significantly decreased.Logistic regression analysis showed that CRP,LDH and albumin levels were independent risk factors for death in patients with COVID-19.Conclusion The elevated levels of CRP and LDH and low albumin levels are of great significance in predicting the adverse outcome of the disease.Monitoring should be strengthened to improve the prognosis of the disease and reduce the mortality.