背景:本研究的目的是分析流行病学,由于SARS-CoV-2感染而入住纳瓦拉大学医院的患者的临床和功能特征,以及死亡率的预测因素,在这种病毒引起的第一波大流行期间。
方法:观察性,进行了回顾性研究,包括所有75岁以上的住院患者。已经获得了关于多个变量的信息,其中值得一提的是以前的老年综合征或住院期间出现的老年综合征,或既往病史被认为与SARS-CoV-2感染有关。对数据的描述性分析,根据不同的关注因素进行比较,并进行多变量分析以分析与死亡率相关的因素.
结果:数据来自总共426名平均年龄为83.2岁的患者(52.6%为男性)。34.7%在医院死亡,4.5%在出院后1个月内死亡。与死亡率相关的因素是:基线功能状态较差,慢性肾病,和发烧或呼吸困难的表现形式。最常见的典型症状是:发烧,呼吸困难,咳嗽,虚弱和缺氧。高达42.1%的谵妄表现为非典型发作的症状。我们观察到功能恶化,随访一个月后仍未恢复(基线Barthel指数81.12;出院时70.08;一个月后75.55)。
结论:SARS-CoV-2感染导致老年人的高死亡率。在这个年龄段,这种疾病的非典型表现和住院期间的功能恶化是常见的。在本研究中,以前较差的功能状态已被确定为死亡率的预测因子.需要更多的研究来评估疾病和住院对老年患者的影响,为了实施预防性,诊断和治疗措施是必要的,以避免功能恶化和不良健康事件相关。
BACKGROUND: The objective of the present study is to analyze the epidemiological, clinical and functional characteristics of patients admitted to the University Hospital of Navarra due to SARS-CoV-2 infection, as well as the predictors of mortality, during the first wave of the pandemic caused by this virus.
METHODS: An observational, retrospective study was performed, including all hospitalized patients older than 75 years. Information has been obtained on multiple variables, among which it is worth mentioning previous geriatric syndromes or those that have appeared during hospitalization, or past medical history considered relevant in SARS-CoV-2 infection. A descriptive analysis of the data, comparisons according to various factors of interest and multivariate analysis to analyze factors associated with mortality were carried out.
RESULTS: Data have been obtained from a total of 426 patients with a mean age of 83.2 years (52.6% men). 34.7% died in hospital and 4.5% within 1 month after hospital discharge. The factors related to mortality were: worse baseline functional status, chronic kidney disease, and fever or dyspnea as forms of presentation. The most frequent typical symptoms were: fever, dyspnea, cough, asthenia and hyporexia. Up to 42.1% presented delirium as a symptom of atypical onset. We observed a functional deterioration that was not recover after a month of follow-up (baseline Barthel index 81.12; 70.08 at discharge; 75.55 after a month).
CONCLUSIONS: SARS-CoV-2 infection has caused high mortality rates in older adults. In this age group, the atypical presentation of this disease and functional deterioration during hospitalization are frequent. In the present study, a worse previous functional status has been identified as a predictor of mortality. More studies are needed to evaluate the impact that the disease and hospitalization have on the older patient, with the aim of implementing preventive, diagnostic and therapeutic measures that are necessary to avoid functional deterioration and adverse health events related to it.