Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

作者：Giacomo Grasselli, Massimiliano Greco, Alberto Zanella, Giovanni Albano, Massimo Antonelli, Giacomo Bellani, Ezio Bonanomi, Luca Cabrini, Eleonora Carlesso, Gianpaolo Castelli, Sergio Cattaneo, Danilo Cereda, Sergio Colombo, Antonio Coluccello, Giuseppe Crescini, Andrea Forastieri Molinari, Giuseppe Foti, Roberto Fumagalli, Giorgio Antonio Iotti, Thomas Länger, Nicola Latronico, Ferdinando Luca Lorini, Francesco Mojoli, Giuseppe Natalini, Carla Pessina, V. Marco Ranieri, Roberto Rech, Luigia Scudeller, Antonio Rosanò, Enrico Storti, Bruce Thompson, Marcello Tirani, Pier Giorgio Villani, Antonio Pesenti, Maurizio Cecconi, COVID-19 Lombardy ICU Network, Emiliano Agosteo, Giovanni Albano, A. Albertin, Armando Alborghetti, Giorgio Aldegheri, Benvenuto Antonini, Enrico Barbara, Giulia Bardelloni, S Basilico, Nicolangela Belgiorno, Giacomo Bellani, Enrico Beretta, Angela Berselli, Leonardo Bianciardi, Ezio Bonanomi, Stefano Bonazzi, Massimo Borelli, Nicola Bottino, Nicola Bronzini, Serena Brusatori, Luca Cabrini, Carlo Capra, Livio Carnevale, Gianpaolo Castelli, E Catena, Sergio Cattaneo, Maurizio Cecconi, Simona Celotti, Stefania Cerutti, Davide Chiumello, Silvia Cirri, Giuseppe Citerio, Sergio Colombo, Antonio Coluccello, Davide Coppini, Alberto Corona, Paolo Cortellazzi, Elena Costantini, Remo Daniel Covello, Giuseppe Crescini, Gianluca De Filippi, Marco Poli, Paolo Dughi, Fulvia Fieni, Gaetano Florio, Andrea Forastieri Molinari, Giuseppe Foti, Roberto Fumagalli, Marco Galletti, G Gallioli, Hedwige Gay, Marco Gemma, Paolo Gnesin, Giacomo Grasselli, Stefano Greco, Massimiliano Greco, Paolo Grosso, Luca Guatteri, Davide Guzzon, Giorgio Antonio Iotti, Roberto Keim, Thomas Länger, Nicola Latronico, Andrea Lombardo, Ferdinando Luca Lorini, Filippo Mamprin, Giovanni Marino, Francesco Marino, Guido Merli, Antonio Micucci, Carmine Rocco Militano, Francesco Mojoli, Giacomo Monti, Stefano Muttini, Samantha Nadalin, Giuseppe Natalini, Paolo Perazzo, Giovanni Battista Perego, Luciano Perotti, Antonio Pesenti, Carla Pessina, Nicola Petrucci, Angelo Pezzi, Simone Piva, Gina Portella, Alessandro Protti, M. Racagni, Danilo Radrizzani, Maurizio Raimondi, Marco Ranucci, Roberto Rech, Mario Riccio, Antonio Rosano, Patrizia Ruggeri, Giuseppe Sala, Luca Salvi, Pietro Sebastiano, Paolo Severgnini, Donato Sigurtà, Nino Stocchetti, Enrico Storti, Matteo Subert, Mario Tavola, Serena Todaro, Francesca Torriglia, Daniela Tubiolo, Roberto Valsecchi, Pier Giorgio Villani, Uberto Viola, Giovanni Vitale, Massimo Zambon, Alberto Zanella, Elena Zoia · 发表于：JAMA Internal Medicine · 年份：2020 · DOI：10.1001/jamainternmed.2020.3539 · 被引用次数：1746 · 研究领域：COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research、Long-Term Effects of COVID-19

Importance: Many patients with coronavirus disease 2019 (COVID-19) are critically ill and require care in the intensive care unit (ICU). Objective: To evaluate the independent risk factors associated with mortality of patients with COVID-19 requiring treatment in ICUs in the Lombardy region of Italy. Design, Setting, and Participants: This retrospective, observational cohort study included 3988 consecutive critically ill patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinating center (Fondazione IRCCS [Istituto di Ricovero e Cura a Carattere Scientifico] Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network from February 20 to April 22, 2020. Infection with severe acute respiratory syndrome coronavirus 2 was confirmed by real-time reverse transcriptase-polymerase chain reaction assay of nasopharyngeal swabs. Follow-up was completed on May 30, 2020. Exposures: Baseline characteristics, comorbidities, long-term medications, and ventilatory support at ICU admission. Main Outcomes and Measures: Time to death in days from ICU admission to hospital discharge. The independent risk factors associated with mortality were evaluated with a multivariable Cox proportional hazards regression. Results: Of the 3988 patients included in this cohort study, the median age was 63 (interquartile range [IQR] 56-69) years; 3188 (79.9%; 95% CI, 78.7%-81.1%) were men, and 1998 of 3300 (60.5%; 95% CI, 58.9%-62.2%) had at least 1 ...