Background: To date, little attention has been paid to the impact of risk factors on the outcome of patients with coronavirus disease 2019 (COVID-19) hospitalized in the intensive care unit (ICU). This study was performed to examine the effects of risk factors on death among COVID-19 patients hospitalized in the ICU. Methods: From April 2020 to November 2020, data on 141 COVID-19-infected intensive care patients at 7 Air Force Hospital, Kanpur, were retrospectively retrieved. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 15.0). Bivariate and multivariate logistic regression analysis was done to identify independent risk factors. A p-value <0.05 was considered statistically significant. Results: Most of study population were males (69.5%) with mean age of 59.8 ± 17.5 years. Out of 141 patients, 60 (42.6%) patients had comorbidities and 81 (57.4%) patients had no comorbidities. ICU death rates were 46.1%. Bivariate logistic regression analysis revealed that male sex (OR:0.45;95%CI:0.21-0.94), diabetes mellitus (OR:2.96; 95%CI:1.16-7.54), coronary artery disease (OR:2.48;95%CI:0.83-7.37), chronic kidney disease (OR:0.13,95% CI:0.02-1.12), patients with one (OR:1.25,95%CI:0.54-2.86) or more than two comorbidities (OR:1.95,95%CI:0.81-4.70), and who required high flow oxygen therapy (OR:13.30,95%CI:5.81-30.43), non-invasive (OR: 0.10,95% CI:0.02-0.45) and invasive ventilators (OR:0.04,95%CI:0.02-0.09) all were associated with higher ICU death rates. Multivariable logistic regression found following independent risk factors for death: patients with one comorbidity (OR:0.10;95%CI:0.02-0.66), non-invasive ventilator (OR:0.005;95%CI:0.000-0.091), and invasive ventilator (OR:0.003;95%CI:0.000-0.032). Conclusion: Identification of risk factors is of utmost importance to reduce death in COVID-19 infected intensive care patients.
Aim: To compare and analyze the duration of analgesia after giving supraclavicular block using bupivacaine with and without intravenous dexamethasone. Methodology: The study was done in a tertiary care teaching hospital over 06 months. All eligible 50 patients were divided into two groups of 25 each. Group A patients receiving block by 40 ml of 0.25% bupivacaine were compared with Group B patients receiving 40 ml of 0.25% bupivacaine along with 8 mg intravenous dexamethasone. Duration of analgesia was calculated from the time of pain relief after block to the appearance of pain or Numerical Scale Rating (NRS) more than four. Any other complications were also noted. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21, IBM Inc. As the data was found to be normally distributed bivariate analyses were performed using an independent t-test. Results: Mean duration of analgesia was found to be significantly more among subjects given Analgesia with bupivacaine and iv dexamethasone as compared to subjects given Analgesia with bupivacaine only as p<0.05. No significant difference was seen in the distribution of complications like nausea and vomiting among the two study group when compared using Chi-square test as p>0.05. Conclusion: In conclusion, the addition of dexamethasone supraclavicular brachial plexus block provides prolongation of the duration of the block and decreases the incidence of postoperative nausea and vomiting that may have a great impact on patient comfort.
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