ABSTRACT
Introduction: It could be beneficial to accelerate the hospitalization of patients with the identified clinical risk factors of intensive care unit (ICU) admission, in order to control and reduce COVID-19-related mortality. This study aimed to determine the clinical risk factors associated with ICU hospitalization of COVID-19 patients. Methods: The current research was a cross-sectional study. The study recruited 7182 patients who had positive PCR tests between February 23, 2020, and September 7, 2021 and were admitted to Afzalipour Hospital in Kerman, Iran, for at least 24 hours. Their demographic characteristics, underlying diseases, and clinical parameters were collected. In order to analyze the relationship between the studied variables and ICU admission, multiple logistic regression model, classification tree, and support vector machine were used. Results: It was found that 14.7 percent (1056 patients) of the study participants were admitted to ICU. The patients' average age was 51.25±21 years, and 52.8% of them were male. In the study, some factors such as decreasing oxygen saturation level (OR=0.954, 95%CI: 0.944-0.964), age (OR=1.007, 95%CI: 1.004-1.011), respiratory distress (OR=1.658, 95%CI: 1.410-1.951), reduced level of consciousness (OR=2.487, 95%CI: 1.721-3.596), hypertension (OR=1.249, 95%CI: 1.042-1.496), chronic pulmonary disease (OR=1.250, 95%CI: 1.006-1.554), heart diseases (OR=1.250, 95%CI: 1.009-1.548), chronic kidney disease (OR=1.515, 95%CI: 1.111-2.066), cancer (OR=1.682, 95%CI: 1.130-2.505), seizures (OR=3.428, 95%CI: 1.615-7.274), and gender (OR=1.179, 95%CI: 1.028-1.352) were found to significantly affect ICU admissions. Conclusions: As evidenced by the obtained results, blood oxygen saturation level, the patient's age, and their level of consciousness are crucial for ICU admission.
ABSTRACT
The quality of life (QoL) questionnaire (SF-36) contains 36 questions in eight subscales. It requires much time to fill in by the respondent. The objective of this study was to use Rasch models to develop a questionnaire that brings the desired outcome of the QoL of people. Therefore, a new questionnaire was provided that is more motivating and time-saving for respondents than SF-36. The QoL of life assessment data of 325 ß-thalassemia major (ß-TM) and ß-thalassemia intermedia (ß-TI) patients in Kerman, Iran, was used as research data. In this study, the appropriate questions were classified in a limited dimensional framework using the exploratory factor analysis (EFA). The correctness of the factor structure was assessed by confirmatory factor analysis (CFA). The quality of the questions was evaluated by Rasch modeling [partial credit model (PCM)] and item analysis to ensure the validity and reliability of the questionnaire. Finally, the Pearson correlation coefficient was used to compare the new questionnaire with the previous one. This process resulted in the development of a new questionnaire with five subscales and 20 questions. The construct validity of the new questionnaire was good. The reliability index of the questionnaire was 0.75, and the Pearson correlation coefficient between the QoL scores gained from the previous and the new questionnaires was 0.93 that indicates the strength of the correlation. The use of Rasch analysis in this study resulted in the development of a new reliable and valid questionnaire.
