Background: Coronavirus disease 2019 (COVID-19) has resulted in an overwhelmed challenge to the healthcare system worldwide. Methods: A case-control study of COVID-19 patients in Wuhan Third Hospital was conducted. 96 deceased COVID-19 patients and 230 discharged patients were included as the case group and control group, respectively. Demographic, epidemiological, clinical and laboratory variables on admission were collected from electronic medical records. Univariate and multivariate logistic regression were adopted to investigate the independent predictors of mortality. A nomogram was formed for predicting the mortality risk. Results: The multivariate stepwise logistic model demonstrated that age of 60+ years (OR =4.426, 95% CI: 1.955-10.019), comorbidity of cerebrovascular disease (OR =7.084, 95% CI: 1.545-32.471), white blood cell (WBC) count >9.5x10(9)/L (OR =7.308, 95% CI: 1.650-32.358), platelet count <125x10(9)/L (OR =5.128, 95% CI: 2.157-12.191), aspartate aminotransferase (AST) >40 U/L (OR =2.554, 95% CI: 1.253-5.206), cystatin C >1.1 mg/L (OR =4.132, 95% CI: 2.118-8.059), C reactive protein (CRP) =100 mg/L (OR =2.830, 95% CI: 1.311-6.109), creatine kinase isoenzymes (CK-MB) >24 U/L (OR =6.015, 95% CI: 2.119-17.07) and D-dimer >5 mu g/L (OR =4.917, 95% CI: 1.619-14.933) were independent predictors of mortality of COVID-19 patients. The nomogram demonstrated a well discriminatory accuracy for mortality prediction with a C-index of 0.903. Conclusions: The determinants identified may help to determine patients at high risk of death at an early stage and guide the optimal treatment.
基金:
Shanghai Municipal Science & Technology Commission Key Scientific and Technological Innovation Action Plan (18411950900), National Nature Science Funds of China (81772107) and Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project (SHDC12017116).
第一作者机构:[1]Shanghai Jiao Tong Univ, Ruijin Hosp, Clin Res Ctr, Sch Med, Shanghai, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[3]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Lab Med, Shanghai, Peoples R China[4]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Clin Microbiol, Sch Med, Shanghai, Peoples R China[6]Shanghai Jiao Tong Univ, Ruijin Hosp, Emergency Dept, Sch Med, Shanghai, Peoples R China[7]Wuhan Univ, Wuhan Hosp 3, Dept Gastroenterol, Tongren Hosp, Wuhan, Peoples R China[*1]Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[*2]Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[*3]Department of Gastroenterology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
推荐引用方式(GB/T 7714):
Li Jian,Yang Luyu,Zeng Qian,et al.Determinants of mortality of patients with COVID-19 in Wuhan, China: a case-control study[J].ANNALS OF PALLIATIVE MEDICINE.2021,10(4):3937-+.doi:10.21037/apm-20-2107.
APA:
Li, Jian,Yang, Luyu,Zeng, Qian,Li, Qingyun,Yang, Zhitao...&Chen, Erzhen.(2021).Determinants of mortality of patients with COVID-19 in Wuhan, China: a case-control study.ANNALS OF PALLIATIVE MEDICINE,10,(4)
MLA:
Li, Jian,et al."Determinants of mortality of patients with COVID-19 in Wuhan, China: a case-control study".ANNALS OF PALLIATIVE MEDICINE 10..4(2021):3937-+