摘要
目的分析老年人新型冠状病毒感染死亡的影响因素。方法收集2023年1月1日至2023年7月8日华西第四医院因新型冠状病毒感染导致死亡的病例资料,并选取同期华西老年人群健康队列中感染新型冠状病毒后存活的病例作为对照,采用LASSO-Logistic回归对倾向性评分匹配后数据进行分析,并通过绘制受试者工作特征曲线对构建的预测模型进行验证。结果共纳入142例新型冠状病毒感染死亡者和3239名存活者。LASSO-Logistic回归分析结果显示,吸烟(OR=3.33,95%CI=1.46~7.59,P=0.004)、脑卒中(OR=3.55,95%CI=1.15~10.30,P=0.022)、恶性肿瘤(OR=19.93,95%CI=8.52~49.23,P<0.001)、冠心病(OR=7.68,95%CI=3.52~17.07,P<0.001)、发热(OR=0.51,95%CI=0.26~0.96,P=0.042)、气喘或呼吸困难(OR=21.48,95%CI=9.44~51.95,P<0.001)、呕吐(OR=8.19,95%CI=2.87~23.58,P<0.001)是新型冠状病毒感染患者死亡的独立危险因素。基于影响因素构建的预测模型在测试集中的曲线下面积为0.889。结论吸烟、脑卒中、恶性肿瘤、冠心病、发热、气喘或呼吸困难以及呕吐是影响新型冠状病毒感染死亡风险的因素。
Objective To analyze the influencing factors of death in the elderly with coronavirus disease 2019(COVID-19).Methods The case data of death caused by COVID-19 in West China Fourth Hospital from January 1 to July 8,2023 were collected,and surviving cases from the West China Elderly Health Cohort infected with COVID-19 during the same period were selected as the control.LASSO-Logistic regression was adopted to analyze the data after propensity score matching and the validity of the model was verified by drawing the receiver operating characteristic curve.Results A total of 3239 COVID-19 survivors and 142 deaths with COVID-19 were included.The results of LASSO-Logistic regression showed that smoking(OR=3.33,95%CI=1.46-7.59,P=0.004),stroke(OR=3.55,95%CI=1.15-10.30,P=0.022),malignant tumors(OR=19.93,95%CI=8.52-49.23,P<0.001),coronary heart disease(OR=7.68,95%CI=3.52-17.07,P<0.001),fever(OR=0.51,95%CI=0.26-0.96,P=0.042),difficulty breathing or asthma symptoms(OR=21.48,95%CI=9.44-51.95,P<0.001),and vomiting(OR=8.19,95%CI=2.87-23.58,P<0.001)increased the risk of death with COVID-19.The prediction model constructed based on the influencing factors achieved an area under the curve of 0.889 in the test set.Conclusions Smoking,stroke,malignant tumors,coronary heart disease,fever,breathing difficulty or asthma symptoms,and vomiting were identified as key factors influencing the death risk in COVID-19.
作者
陈莹
黄海平
李鑫
柴思捷
叶家利
周丁子
张韬
CHEN Ying;HUANG Haiping;LI Xin;CHAI Sijie;YE Jiali;ZHOU Dingzi;ZHANG Tao(Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Sichuan Tianfu New District Public Health Center,Chengdu 610213,China;Department of Pneumoconiosis/Department of Respiratory and Critical Care Medicine,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国医学科学院学报》
北大核心
2025年第3期375-381,共7页
Acta Academiae Medicinae Sinicae
基金
国家重点研发计划(2022YFC3600604)
四川省预防医学会基层公共卫生专项科研项目(SYYXH202403、SYYXHPT202406)
四川省科技计划项目(2024ZYD0102、2025YFHZ0069)
成都市科技局项目(2024-YF05-01784-SN)
新型冠状病毒感染临床结局分析研究(H230413)
四川天府新区公共卫生中心成果梳理技术咨询服务项目(H230821)。
