학술논문
Critically ill COVID-19 patients in northeast Brazil: mortality predictors during the first and second waves including SAPS 3.
Document Type
Academic Journal
Author
Lázaro APP; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Post-Graduate Program in Public Health, University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Albuquerque PLMM; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Instituto Doutor Jose Frota Hospital, R. Barão do Rio Branco, 1816, Fortaleza, CE, 60025-061, Brazil.; Meneses GC; Post-Graduate Program in Medical Sciences, Federal University of Ceara, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Zaranza MS; Instituto Doutor Jose Frota Hospital, R. Barão do Rio Branco, 1816, Fortaleza, CE, 60025-061, Brazil.; Post-Graduate Program in Medical Sciences, Federal University of Ceara, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Batista AB; Instituto Doutor Jose Frota Hospital, R. Barão do Rio Branco, 1816, Fortaleza, CE, 60025-061, Brazil.; Aragão NLP; Instituto Doutor Jose Frota Hospital, R. Barão do Rio Branco, 1816, Fortaleza, CE, 60025-061, Brazil.; Beliero AM; Instituto Doutor Jose Frota Hospital, R. Barão do Rio Branco, 1816, Fortaleza, CE, 60025-061, Brazil.; Guimarães ÁR; Federal University of Ceara, Av. da Universidade, 2853, Fortaleza, CE, 60020-181, Brazil.; Aragão NL; Post-Graduate Program in Medical Sciences, Federal University of Ceara, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Leitão AMM; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; de Carvalho MCF; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Cavalcante MIA; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Mota FAX; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Daher EF; Post-Graduate Program in Medical Sciences, Federal University of Ceara, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Martins AMC; Post-Graduate Program in Pharmaceutical Sciences, Federal University of Ceara, Rua Capitão Francisco Pedro, 1210 , Fortaleza, CE, 60.430-370, Brazil.; da Silva Junior GB; University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Post-Graduate Program in Public Health, University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.; Post-Graduate Program in Medical Sciences, University of Fortaleza, Av. Washington Soares, 1321, Fortaleza, CE, 60811-905, Brazil.
Source
Publisher: Oxford University Press Country of Publication: England NLM ID: 7506129 Publication Model: Print Cited Medium: Internet ISSN: 1878-3503 (Electronic) Linking ISSN: 00359203 NLM ISO Abbreviation: Trans R Soc Trop Med Hyg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The Simplified Acute Physiology Score (SAPS) 3 is a reliable score to predict mortality. This study aims to investigate the predictive values of SAPS 3 and other clinical parameters for death in critically ill coronavirus disease 2019 (COVID-19) patients.
Methods: This is a prospective study in a tertiary hospital for patients who required intensive care due to COVID-19 infection in northeast Brazil. Two distinct groups were constructed according to the epidemiological data: first wave and second wave. The severity of patients admitted was estimated using the SAPS 3 score.
Results: A total of 767 patients were included: 290 were enrolled in the first wave and 477 in the second wave. Patients in the first wave had more comorbidities, were put on mechanical ventilation and required dialysis and vasopressors more frequently (p<0.05). During the second wave, non-invasive ventilation was more often required (p<0.05). In both periods, older patients and higher SAPS 3 scores on admission were associated with death (p<0.05). Non-invasive ventilation use showed a negative association with death only in the second wave period. In the first wave, the SAPS 3 score was more useful (area under the curve [AUC] 0.897) in predicting death in critically ill COVID-19 patients than in the second wave (AUC 0.810).
Conclusion: The SAPS 3 showed very reliable predictive values for death during the waves of the COVID-19 pandemic, mostly together with kidney and pulmonary dysfunction.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)
Methods: This is a prospective study in a tertiary hospital for patients who required intensive care due to COVID-19 infection in northeast Brazil. Two distinct groups were constructed according to the epidemiological data: first wave and second wave. The severity of patients admitted was estimated using the SAPS 3 score.
Results: A total of 767 patients were included: 290 were enrolled in the first wave and 477 in the second wave. Patients in the first wave had more comorbidities, were put on mechanical ventilation and required dialysis and vasopressors more frequently (p<0.05). During the second wave, non-invasive ventilation was more often required (p<0.05). In both periods, older patients and higher SAPS 3 scores on admission were associated with death (p<0.05). Non-invasive ventilation use showed a negative association with death only in the second wave period. In the first wave, the SAPS 3 score was more useful (area under the curve [AUC] 0.897) in predicting death in critically ill COVID-19 patients than in the second wave (AUC 0.810).
Conclusion: The SAPS 3 showed very reliable predictive values for death during the waves of the COVID-19 pandemic, mostly together with kidney and pulmonary dysfunction.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)