1. Temporal patterns of organ dysfunction in COVID-19 patients hospitalized in the intensive care unit: A group-based multitrajectory modeling analysis
- Author
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Jiafei Yu, Kai Zhang, Tianqi Chen, Ronghai Lin, Qijiang Chen, Chensong Chen, Minfeng Tong, Jianping Chen, Jianhua Yu, Yuhang Lou, Panpan Xu, Chao Zhong, Qianfeng Chen, Kangwei Sun, Liyuan Liu, Lanxin Cao, Cheng Zheng, Ping Wang, Qitao Chen, Qianqian Yang, Weiting Chen, Xiaofang Wang, Zuxi Yan, Xuefeng Zhang, Wei Cui, Lin Chen, Zhongheng Zhang, and Gensheng Zhang
- Subjects
COVID-19 ,Intensive care unit ,Sequential organ failure assessment score ,Multiple-organ dysfunction ,Group-based multitrajectory modeling ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background: The course of organ dysfunction (OD) in Corona Virus Disease 2019 (COVID-19) patients is unknown. Herein, we analyze the temporal patterns of OD in intensive care unit-admitted COVID-19 patients. Methods: Sequential organ failure assessment scores were evaluated daily within 2 weeks of admission to determine the temporal trajectory of OD using group-based multitrajectory modeling (GBMTM). Results: A total of 392 patients were enrolled with a 28-day mortality rate of 53.6%. GBMTM identified four distinct trajectories. Group 1 (mild OD, n = 64), with a median APACHE II score of 13 (IQR 9-21), had an early resolution of OD and a low mortality rate. Group 2 (moderate OD, n = 140), with a median APACHE II score of 18 (IQR 13-22), had a 28-day mortality rate of 30.0%. Group 3 (severe OD, n = 117), with a median APACHR II score of 20 (IQR 13-27), had a deterioration trend of respiratory dysfunction and a 28-day mortality rate of 69.2%. Group 4 (extremely severe OD, n = 71), with a median APACHE II score of 20 (IQR 17-27), had a significant and sustained OD affecting all organ systems and a 28-day mortality rate of 97.2%. Conclusions: Four distinct trajectories of OD were identified, and respiratory dysfunction trajectory could predict nonpulmonary OD trajectories and patient prognosis.
- Published
- 2024
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