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Revista de la Facultad de Medicina
Print version ISSN 0120-0011
Abstract
RAMIREZ-VELEZ, Andrés et al. Factors associated with mortality in COVID-19 patients admitted to an intensive care unit in Medellín, Colombia. March-December 2020. rev.fac.med. [online]. 2023, vol.71, n.2, e3. Epub July 05, 2024. ISSN 0120-0011. https://doi.org/10.15446/revfacmed.v71n2.97986.
Introduction:
COVID-19 is mild in 80% of cases; however, it progresses to severe disease in 5% of patients, thus requiring intensive care unit (ICU) admission.
Objective:
To identify demographic, clinical, and treatment-related factors associated with mortality in patients with COVID-19 treated at the ICU of a quaternary care hospital in Medellín, Colombia.
Materials and methods:
Retrospective cohort study. The medical records of 182 patients admitted to the ICU between March and December 2020 due to COVID-19 were analyzed. Bivariate analyses (chi-square, Fisher's exact, unpaired Student's t test, or Mann-Whitney U test) were performed to evaluate the association between demographic characteristics, presence of coexisting diseases, laboratory results, therapeutic interventions, ventilatory and hemodynamic support requirement, and mortality. In addition, a multivariate analysis was performed, in which simple and multiple binary logistic regressions were used, calculating crude and adjusted relative risks (RR). A significance level of p<0.05 was considered.
Results:
Mortality was reported in 47.80% of patients. In the multivariate analysis model, the following factors were protective factors: age <60 years (aRR: 0.154, 95%CI: 0.059-0.401; p=0.000), use of vasopressors (aRR: 0.082, 95%CI: 0.021-0.319; p<0.001), and use of renal replacement therapy (aRR: 0.205 95%CI 0.059 - 0.716; p=0.013). On the other hand, not performing tracheostomy was an independent protective factor for mortality (aRR: 14.959, 95%CI: 4.865-45.998; p<0.001). A lower platelet count during the ICU stay had a neutral effect, although it was a significantly associated quantitative variable (aRR: 0.999, 95%CI: 0.990-0.999; p=0.003).
Conclusions:
In the present study, age <60 years, the use of vasopressors, and renal replacement therapy were protective factors, while not performing tracheostomy was a risk factor for mortality. Furthermore, a lower platelet count during ICU stay was a significantly associated quantitative variable.
Keywords : Coronavirus Infections; Intensive Care Unit; Respiratory Distress Syndrome, Acute; Ventilation, Mechanical; Mortality (MeSH).