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J Korean Soc Emerg Med > Volume 33(1); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(1): 94-105.
Mortality prognostic factors of COVID-19 in the emergency department during outbreak in Daegu, Korea: a multicenter retrospective study
Jong-yeon Kim1 , Jung Ho Kim2 , Hyun Wook Ryoo3 , Jae Yun Ahn3 , Sungbae Moon3 , Dong Eun Lee4 , Sang Hun Lee5 , You Ho Mun1 , Tae Chang Jang6
1Department of Public Health, Kyungpook National University Hospital, Daegu, Korea
2Department of Emergency Medicine, Yeungnam National University Hospital, Daegu, Korea
33 Department of Emergency Medicine, Kyungpook National University Hospital, Daegu, Korea
4Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
5Department of Emergency Medicine, Kyungpook National University Dongsan Hospital, Daegu, Korea
6Department of Emergency Medicine, Daegu Catholic University Hospital, Daegu, Korea
Correspondence  Jung Ho Kim ,Tel: 053-620-3191, Fax: 053-624-8030, Email: jhkimem@naver.com,
Received: January 26, 2021; Revised: March 29, 2021   Accepted: April 6, 2021.  Published online: February 28, 2022.
ABSTRACT
Objective:
We aimed to investigate the characteristics and prognostic factors of coronavirus disease 2019 (COVID-19) patients in the emergency departments (EDs) in Daegu, Korea, the region with the second regional outbreak worldwide.
Method:
We conducted a retrospective observational multicenter study using a population-based COVID-19 registry of EDs. We included the demographic, clinical and laboratory data. Cox proportional hazard regression analysis was performed to identify the prognostic factors of mortality.
Results:
A total of 241 patients were included in this study. In the Cox hazard regression model (hazard ratio [95% confidence interval]), age (65-79 years: 3.531 [1.529-8.156], ≥80 years: 5.335 [2.229-12.770]), respiratory rate (RR) (>20 breaths/min: 2.025 [1.205-3.403], ≤11 breaths/min: 111.292 [30.845-401.555]), lymphocyte counts <1.0×109/L (2.611 [1.494-4.739]), blood urea nitrogen (BUN) levels>23 mg/dL (2.047 [1.233-3.399]), aspartate aminotransferase (AST) levels>40 IU/L (1.785 [1.009-3.158]) and neutrophil counts>6.3×109/L (1.638 [1.014-2.644]) were associated with mortality.
Conclusion:
Age, RR, lymphocyte counts, BUN levels, AST levels and neutrophil counts were prognostic factors in COVID-19 patients in the ED. These factors can help effectively treat and reduce mortality through optimized management of COVID-19 patients, in places with limited emergency medical resources such as massive regional outbreaks.
Key words: Coronavirus; Disease outbreaks; Emergency treatment; Prognosis; Mortality
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