Aging-related predictive factors for oxygenation improvement and mortality in COVID-19 and acute respiratory distress syndrome (ARDS) patients exposed to prone position: A multicenter cohort study
Clinics
;
78: 100180, 2023. tab
Article
Dans Anglais
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LILACS-Express
| LILACS
| ID: biblio-1439917
ABSTRACT
Abstract Background:
Elderly patients are more susceptible to Coronavirus Disease-2019 (COVID-19) and are more likely to develop it in severe forms, (e.g., Acute Respiratory Distress Syndrome [ARDS]). Prone positioning is a treatment strategy for severe ARDS; however, its response in the elderly population remains poorly understood. The main objective was to evaluate the predictive response and mortality of elderly patients exposed to prone positioning due to ARDS-COVID-19.Methods:
This retrospective multicenter cohort study involved 223 patients aged ≥ 65 years, who received prone position sessions for severe ARDS due to COVID-19, using invasive mechanical ventilation. The PaO2/FiO2 ratio was used to assess the oxygenation response. The 20-point improvement in PaO2/FiO2 after the first prone session was considered for good response. Data were collected from electronic medical records, including demographic data, laboratory/image exams, complications, comorbidities, SAPS III and SOFA scores, use of anticoagulants and vasopressors, ventilator settings, and respiratory system mechanics. Mortality was defined as deaths that occurred until hospital discharge.Results:
Most patients were male, with arterial hypertension and diabetes mellitus as the most prevalent comorbidities. The non-responders group had higher SAPS III and SOFA scores, and a higher incidence of complications. There was no difference in mortality rate. A lower SAPS III score was a predictor of oxygenation response, and the male sex was a risk predictor of mortality.Conclusion:
The present study suggests the oxygenation response to prone positioning in elderly patients with severe COVID-19-ARDS correlates with the SAPS III score. Furthermore, the male sex is a risk predictor of mortality.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Type d'étude:
Essai clinique contrôlé
/
Etude d'étiologie
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Étude observationnelle
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Étude pronostique
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Facteurs de risque
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2023
Type:
Article
/
descriptif de projet
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Santa Casa de Misericordia de Belo Horizonte/BR
/
Tacchini Hospital/BR
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Universidade Federal de Ciências da Saúde de Porto Alegre/BR
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Universidade Federal de Santa Catarina/BR
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Universidade Federal de Santa Maria (UFSM)/BR
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Universidade Federal de Santa Maria/BR
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Universidade de Sao Paulo/BR
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Universidade do Estado de Santa Catarina/BR
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