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
in English
|
LILACS-Express
| LILACS
| ID: biblio-1439917
Responsible library:
BR1.1
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.
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 6: Information systems for health
Database:
LILACS
Type of study:
Controlled clinical trial
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Etiology study
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Observational study
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Prognostic study
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Risk factors
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2023
Document type:
Article
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Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Santa Casa de Misericordia de Belo Horizonte/BR
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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