سال 15، شماره 6 - ( آذر - دی 1400 )                   جلد 15 شماره 6 صفحات 624-612 | برگشت به فهرست نسخه ها

XML English Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Amini P, Sepehrvand N, Sharhani A, Zarei J, Ghanbari S. Evaluating the Mode of Presentation to Hospital and Time to Death/Discharge in Patients with COVID-19 in Southwest Iran: A Joint Modelling Approach. Iran J Med Microbiol. 2021; 15 (6) :612-624
URL: http://ijmm.ir/article-1-1413-fa.html
امینی پیام، سپهروند نریمان، شرهانی اسعد، زارعی جواد، قنبری سعید. ارزیابی نحوه مراجعه به بیمارستان تا زمان مرگ/ترخیص بیماران مبتلا به کووید-19 در خوزستان، ایران: با رویکرد مدلسازی توام. مجله میکروب شناسی پزشکی ایران. 1400; 15 (6) :624-612

URL: http://ijmm.ir/article-1-1413-fa.html

1- گروه آمار زیستی و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران
2- گروه پزشکی، دانشگاه آلبرتا، ادمونتون، کانادا
3- گروه فناوری اطلاعات سلامت، دانشکده پیراپزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران
4- گروه آمار زیستی و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران ، saeedghanbari6.24@gmail.com
چکیده:   (1443 مشاهده)

Background and Objective: Recently, coronavirus has become a major cause of death and hospital admission worldwide. This study was aimed to assess the factors associated with the presentation via ambulance and time to in-hospital death or discharge from the hospital using a multilevel joint modeling approach.
Materials and Methods: In this historical cohort study, hospitalized patients with COVID-19 were included from 34 medical centers in Khuzestan province, Iran, from February 18th, 2020, to January 5th, 2021. Joint model analysis was used to assess the impact of demographic and clinical characteristics on the mode of hospital presentation and time to death/discharge from hospitals in Khuzestan province, Iran.
Results: Among 22,356 patients, 14.2% presented to the hospital via ambulance, and 11.2% died in the hospital. The odds of ambulance use was higher in patients with older age, male sex, comorbidities including respiratory disease, diabetes, cancer, and drug abuse, and symptoms such as respiratory distress and loss of consciousness. Older age, male sex, a higher burden of comorbidities, symptoms of chest pain, respiratory distress, and loss of consciousness, and admission to intensive care unit were predictors of in-hospital mortality. The median survival time was longer for patients with COVID-19 who self-presented to the hospital compared to those who presented with ambulance (31 vs 20 days; log-rank P<0.001).
Conclusion: Several demographic and clinical factors were found to predict the EMS utilization and in-hospital mortality in patients hospitalized with COVID-19 and can be used for risk-stratification. Controlling for the predictors of ambulance use in COVID-19 infection may help improve patient outcomes.

متن کامل [PDF 685 kb]   (420 دریافت)    
نوع مطالعه: مقاله پژوهشی | موضوع مقاله: ویروس شناسی پزشکی
دریافت: 1400/5/13 | پذیرش: 1400/7/17 | انتشار الکترونیک: 1400/9/17

فهرست منابع
1. Varela-Santos S, Melin P. A new approach for classifying coronavirus COVID-19 based on its manifestation on chest X-rays using texture features and neural networks. Inf Sci. 2021;545:403-14. [DOI:10.1016/j.ins.2020.09.041] [PMID] [PMCID]
2. Schettino M, Pellegrini L, Picascia D, Saibeni S, Bezzio C, Bini F, et al. Clinical Characteristics of COVID-19 Patients With Gastrointestinal Symptoms in Northern Italy: A Single-Center Cohort Study. Am J Gastroenterol. 2021;116(2):306-10. [DOI:10.14309/ajg.0000000000000965] [PMID]
3. Zand AD, Heir AV. Environmental impacts of new Coronavirus outbreak in Iran with an emphasis on waste management sector. J Mater Cycles. 2021;23(1):240-7. [DOI:10.1007/s10163-020-01123-1] [PMCID]
4. Zarei J, Dastoorpoor M, Jamshidnezhad A, Cheraghi M, Sheikhtaheri A. Regional COVID-19 registry in Khuzestan, Iran: A study protocol and lessons learned from a pilot implementation. Inform Med Unlocked. 2021;23:100520. [DOI:10.1016/j.imu.2021.100520] [PMID] [PMCID]
5. Raeisi A, Tabrizi JS, Gouya MM. IR of Iran National Mobilization against COVID-19 Epidemic. Arch Iran Med. 2020;23(4):216-9. [DOI:10.34172/aim.2020.01] [PMID]
6. Chen BE, Wang J. Joint modeling of binary response and survival for clustered data in clinical trials. Stat Med. 2020;39(3):326-39. [DOI:10.1002/sim.8403] [PMID]
7. Boothroyd LJ, Lambert LJ, Segal E, Ross D, Kouz S, Maire S, et al. Comparison of outcomes of ambulance users and nonusers in ST elevation myocardial infarction. The American journal of cardiology. 2014;114(9):1289-94. [DOI:10.1016/j.amjcard.2014.07.060] [PMID]
8. Kaul P, Welsh RC, Liu W, Savu A, Weiss DR, Armstrong PW. Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction. The Canadian journal of cardiology. 2016;32(8):949-55. [DOI:10.1016/j.cjca.2015.09.017] [PMID]
9. Sepehrvand N, Alemayehu W, Kaul P, Pelletier R, Bello AK, Welsh RC, et al. Ambulance use, distance and outcomes in patients with suspected cardiovascular disease: a registry-based geographic information system study. European heart journal Acute cardiovascular care. 2020;9(1_suppl):45-58. [DOI:10.1177/2048872618769872] [PMID]
10. Smith EE, Shobha N, Dai D, Olson DM, Reeves MJ, Saver JL, et al. Risk score for in-hospital ischemic stroke mortality derived and validated within the Get With the Guidelines-Stroke Program. Circulation. 2010;122(15):1496-504. [DOI:10.1161/CIRCULATIONAHA.109.932822] [PMID]
11. Boehringer B, O'Meara P, Wingrove G, Nudell NG. An Emergency Amendment to the National Scope of Practice for Paramedics in the Setting of a Global Pandemic. J Rural Health. 2021;37(1):191-3. [DOI:10.1111/jrh.12441] [PMID] [PMCID]
12. Cabanas JG, Williams JG, Gallagher JM, Brice JH. COVID-19 Pandemic: The Role of EMS Physicians in a Community Response Effort. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors. 2021;25(1):8-15. [DOI:10.1080/10903127.2020.1838676] [PMID]
13. Ghazali DA, Ouersighni A, Gay M, Audebault V, Pavlovsky T, Casalino E. Feedback to Prepare EMS Teams to Manage Infected Patients with COVID-19: A Case Series. Prehospital and disaster medicine. 2020;35(4):451-3. [DOI:10.1017/S1049023X20000783] [PMID] [PMCID]
14. Jensen T, Holgersen MG, Jespersen MS, Blomberg SN, Folke F, Lippert F, et al. Strategies to Handle Increased Demand in the COVID-19 Crisis: A Coronavirus EMS Support Track and a Web-Based Self-Triage System. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors. 2021;25(1):28-38. [DOI:10.1080/10903127.2020.1817212] [PMID]
15. Masterson S, Heffernan E, Keegan D, Clarke B, Deasy C, O'Donnell C, et al. Rapid response and learning for later: establishing high quality information networks and evaluation frameworks for the National Ambulance Service response to COVID-19 - the ENCORE COVID Project Protocol. HRB Open Res. 2020;3(68):68. [DOI:10.12688/hrbopenres.13149.1] [PMID] [PMCID]
16. Ng QX, Lee EZ, Tay JA, Arulanandam S. Impact of COVID-19 'circuit-breaker' measures on emergency medical services utilisation and out-of-hospital cardiac arrest outcomes in Singapore. Emerg Med Australas. 2021;33(1):149-51. [DOI:10.1111/1742-6723.13668] [PMID]
17. Al-Wathinani A, Hertelendy AJ, Alhurishi S, Mobrad A, Alhazmi R, Altuwaijri M, et al. Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: A National Retrospective Study. Healthcare (Basel). 2020;9(1):14. [DOI:10.3390/healthcare9010014] [PMID] [PMCID]
18. Jaffe E, Sonkin R, Alpert EA, Magid A, Knobler HY. Flattening the COVID-19 Curve: The Unique Role of Emergency Medical Services in Containing a Global Pandemic. The Israel Medical Association journal : IMAJ. 2020;22(8):476-82.
19. Saberian P, Conovaloff JL, Vahidi E, Hasani-Sharamin P, Kolivand PH. How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. The western journal of emergency medicine. 2020;21(6):110-6. [DOI:10.5811/westjem.2020.8.48679] [PMID] [PMCID]
20. Lerner EB, Newgard CD, Mann NC. Effect of the Coronavirus Disease 2019 (COVID-19) Pandemic on the U.S. Emergency Medical Services System: A Preliminary Report. Acad Emerg Med. 2020;27(8):693-9. [DOI:10.1111/acem.14051] [PMID] [PMCID]
21. Satty T, Ramgopal S, Elmer J, Mosesso VN, Martin-Gill C. EMS responses and non-transports during the COVID-19 pandemic. Am J Emerg Med. 2021;42:1-8. [DOI:10.1016/j.ajem.2020.12.078] [PMID] [PMCID]
22. Ferron R, Agarwal G, Cooper R, Munkley D. The effect of COVID-19 on emergency medical service call volumes and patient acuity: a cross-sectional study in Niagara, Ontario. BMC Emerg Med. 2021;21(1):39. [DOI:10.1186/s12873-021-00431-5] [PMID] [PMCID]
23. Wong LE, Hawkins JE, Langness S, Murrell KL, Iris P, Sammann A. Where Are All the Patients? Addressing Covid-19 Fear to Encourage Sick Patients to Seek Emergency Care. NEJM Catal Innov Care Deliv. 2020:10.1056/CAT.20.0193.
24. Alamdari NM, Afaghi S, Rahimi FS, Tarki FE, Tavana S, Zali A, et al. Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. Tohoku J Exp Med. 2020;252(1):73-84. [DOI:10.1620/tjem.252.73] [PMID]
25. Cecconi M, Piovani D, Brunetta E, Aghemo A, Greco M, Ciccarelli M, et al. Early Predictors of Clinical Deterioration in a Cohort of 239 Patients Hospitalized for Covid-19 Infection in Lombardy, Italy. J Clin Med. 2020;9(5):1548. [DOI:10.3390/jcm9051548] [PMID] [PMCID]
26. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1091. [DOI:10.1136/bmj.m1091] [PMID] [PMCID]
27. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524. [DOI:10.1183/13993003.00524-2020] [PMID] [PMCID]
28. Imam Z, Odish F, Gill I, O'Connor D, Armstrong J, Vanood A, et al. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States. J Intern Med. 2020;288(4):469-76. [DOI:10.1111/joim.13119] [PMID] [PMCID]
29. Sobhani S, Aryan R, Kalantari E, Soltani S, Malek N, Pirzadeh P, et al. Association between Clinical Characteristics and Laboratory Findings with Outcome of Hospitalized COVID-19 Patients: A Report from Northeast Iran. Interdiscip Perspect Infect Dis. 2021;2021:5552138. [DOI:10.1155/2021/5552138] [PMID] [PMCID]
30. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. [DOI:10.1016/S0140-6736(20)30566-3]
31. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8. [DOI:10.1016/j.jaci.2020.04.006] [PMID] [PMCID]
32. Tian J, Yuan X, Xiao J, Zhong Q, Yang C, Liu B, et al. Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study. The Lancet Oncology. 2020;21(7):893-903. [DOI:10.1016/S1470-2045(20)30309-0]
33. Sun H, Ning R, Tao Y, Yu C, Deng X, Zhao C, et al. Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study. J Am Geriatr Soc. 2020;68(6):E19-E23. [DOI:10.1111/jgs.16533]
34. Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. The Journal of infection. 2020;81(2):e16-e25. [DOI:10.1016/j.jinf.2020.04.021] [PMID] [PMCID]
35. Chen J, Bai H, Liu J, Chen G, Liao Q, Yang J, et al. Distinct Clinical Characteristics and Risk Factors for Mortality in Female Inpatients With Coronavirus Disease 2019 (COVID-19): A Sex-stratified, Large-scale Cohort Study in Wuhan, China. Clin Infect Dis. 2020;71(12):3188-95. [DOI:10.1093/cid/ciaa920] [PMID] [PMCID]
36. Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. [DOI:10.1016/j.metabol.2020.154262] [PMID] [PMCID]
37. Sohrabi MR, Amin R, Maher A, Bahadorimonfared A, Janbazi S, Hannani K, et al. Sociodemographic determinants and clinical risk factors associated with COVID-19 severity: a cross-sectional analysis of over 200,000 patients in Tehran, Iran. BMC infectious diseases. 2021;21(1):474. [DOI:10.1186/s12879-021-06179-4] [PMID] [PMCID]
38. Yi Y, Lagniton PNP, Ye S, Li E, Xu RH. COVID-19: what has been learned and to be learned about the novel coronavirus disease. International journal of biological sciences. 2020;16(10):1753-66. [DOI:10.7150/ijbs.45134] [PMID] [PMCID]
39. Zali A, Gholamzadeh S, Mohammadi G, Azizmohammad Looha M, Akrami F, Zarean E, et al. Baseline Characteristics and Associated Factors of Mortality in COVID-19 Patients; an Analysis of 16000 Cases in Tehran, Iran. Arch Acad Emerg Med. 2020;8(1):e70.
40. Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging. 2020;12(7):6049-57. [DOI:10.18632/aging.103000] [PMID] [PMCID]
41. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5). [DOI:10.1183/13993003.01227-2020] [PMID] [PMCID]
42. Trigo J, Garcia-Azorin D, Planchuelo-Gomez A, Martinez-Pias E, Talavera B, Hernandez-Perez I, et al. Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study. J Headache Pain. 2020;21(1):94. [DOI:10.1186/s10194-020-01165-8] [PMID] [PMCID]
43. Hong KH, Choi JP, Hong SH, Lee J, Kwon JS, Kim SM, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73(3):286-9. [DOI:10.1136/thoraxjnl-2016-209313] [PMID]
44. Jia N, Feng D, Fang LQ, Richardus JH, Han XN, Cao WC, et al. Case fatality of SARS in mainland China and associated risk factors. Tropical medicine & international health : TM & IH. 2009;14 Suppl 1(Suppl 1):21-7. [DOI:10.1111/j.1365-3156.2008.02147.x] [PMID] [PMCID]
45. Park J, Yu HT. The Impact of Ignoring the Level of Nesting Structure in Nonparametric Multilevel Latent Class Models. Educ Psychol Meas. 2016;76(5):824-47. [DOI:10.1177/0013164415618240] [PMID] [PMCID]
46. Saberian P, Rafiemanesh H, Sadeghi M, Hasani-Sharamin P, Dadashi F, Baratloo A. The Geographical Distribution of Probable COVID-19 Patients Transferred by Tehran Emergency Medical Services; a Cross Sectional Study. Arch Acad Emerg Med. 2021;9(1):e25.

ارسال نظر درباره این مقاله : نام کاربری یا پست الکترونیک شما:

ارسال پیام به نویسنده مسئول

بازنشر اطلاعات
Creative Commons License این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است.

کلیه حقوق این وب سایت متعلق به مجله میکروب شناسی پزشکی ایران می باشد.

طراحی و برنامه نویسی : یکتاوب افزار شرق   ناشر: موسسه فرنام

© 2022 CC BY-NC 4.0 | Iranian Journal of Medical Microbiology

Designed & Developed by : Yektaweb Publishr: Farname Inc.