Medicina - Palmira
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Browsing Medicina - Palmira by Subject "Acute Respiratory Distress Syndrome"
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Item Factores asociados a mortalidad en pacientes con COVID-19 y síndrome de distrés respiratorio agudo manejados con decúbito prono y ventilación mecánica invasiva(Universidad Santiago de Cali, 2024) Hoyos de Armas, Beatriz Helena; Lozada Ramos, Heiler (Director); Daza Arana, Jorge Enrique (Director)This observational analytical case-control study conducted in an ICU in Valle del Cauca, Colombia, aimed to identify risk factors associated with mortality in $122$ adult patients with severe COVID-19 requiring invasive mechanical ventilation and prone positioning. Despite intensive management, which has historically shown a case-fatality rate of up to $50\%$, the bivariate analysis found that age $>65$ years, lack of prior vaccination, thrombocytopenia, high SOFA score, and the need for vasopressors and inotropes were significantly associated with mortality. A multivariate logistic regression model concluded that a history of Diabetes Mellitus (OR $44.91$), COPD (OR $7.74$), autoimmune disease (OR $17.84$), incomplete COVID-19 vaccination status (OR $29.87$), requirement for vasopressors (OR $8.37$) and inotropes (OR $40.99$), and a severe Modified RALE score (OR $7.01$) were independent risk factors for mortality. The study highlights that clinical history, vaccination status, and ICU admission status significantly influence hospital mortality outcomes in severely ill COVID-19 subjects, which is crucial for alerting clinicians to the risk profile of critically ill adult patients during the acute stage of SARS-CoV-2 infection.