ABSTRACT
Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.
ABSTRACT
Objetivo. Determinar los factores de riesgo sociodemográficos y clínicos relacionados con la mortalidad en pacientes COVID-19 en un Hospital del norte de Perú. Material y Métodos: la investigación se llevó a cabo en un Hospital del norte de Perú. La población la constituyeron 208 Historias Clínicas de pacientes COVID-19 atendidos entre Marzo a Julio del 2020. La variable independiente fueron los factores sociodemográficos tales como la edad, sexo y el estado civil y los factores clínicos como antecedentes epidemiológicos, los factores de riesgo (co-morbilidades) y el estado de salud y la variable dependiente fue la mortalidad Covid-19. Resultados: La mortalidad COVID-19 alcanzó al 46,20 % en pacientes mayores 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %), con antecedentes epidemiológicos (37,5%), y factores de riesgo (comorbilidad) un 74,50 %, principalmente asociados con hipertensión arterial (8,2%), obesidad (3,4%) y diabetes mellitus II (1,9%), y comorbilidades indeterminadas (Otras) un 6,7%. No se presentó mortalidad en los pacientes cuyo estado de salud era Estable, mientras que los pacientes con estado de salud reservado y fallecieron representaron un 46,2%. Conclusión: La mortalidad por COVID-19 alcanzó un 46,20%; mayores de 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %). Se encontró relación significativa entre factores sociodemográficos como la edad, factores clínicos (comorbilidad), en su mayoría hipertensión arterial, obesidad y diabetes mellitus II, y pacientes con estado de salud reservado con la mortalidad del COVID-19.
Objetive. To determine the sociodemographic and clinical risk factors related to mortality in COVID-19 patients in a Hospital in northern Peru. Material and Methods: the research was carried out in a Hospital in the north of Peru. The population was made up of 208 Clinical Histories of COVID-19 patients seen between March and July 2020. The independent variable was sociodemographic factors such as age, sex and marital status, and clinical factors such as epidemiological history, risk factors (co-morbidities) and health status and the dependent variable was Covid-19 mortality. Results: COVID-19 mortality reached 46.20% in patients older than 65 years (51.90%), male (60.40%) and married (65.40%), with an epidemiological history (37.5%) , and risk factors (comorbidity) 74.50%, mainly associated with arterial hypertension (8.2%), obesity (3.4%) and diabetes mellitus II (1.9%), and indeterminate comorbidities (Others) 6.7%. There was no mortality in patients whose health status was Stable, while patients with reserved health status and who died represented 46.2%. Conclusion: mortality from COVID-19 reached 46.20%; older than 65 years (51.90%),male(60.40%) and married (65.40%). A significant relationship was found between sociodemographic factors such as age, clinical factors (comorbidity), mostly arterial hypertension, obesity and diabetes mellitus II, and patients with a reserved health status with the mortality of COVID-19.