ИВАНОВА Альбина Аммосовна – д.м.н., зав. кафедрой
IVANOVA Albina Ammosovna – MD, Head, Department of Anesthesiology, Resuscitation and Intensive Care with the course of Emergency Medicine, Faculty of Postgraduate Training of Doctors
ПОТАПОВ Александр Филиппович – д.м.н., проф.
POTAPOV Alexander Filippovich – MD, Professor, Department of Anesthesiology, Resuscitation and Intensive Care with the course of Emergency Medicine, Faculty of Postgraduate Training of Doctors
ЧУЛАКОВА Надежда Александровна – аспирант
CHULAKOVA Nadezhda Alexandrovna – 3d-year postgraduate student, Department of Anesthesiology, Resuscitation and Intensive Care with the course of Emergency Medicine, Faculty of Postgraduate Training of Doctors
ЧУЛАКОВ Кирилл Викторович – зав. отд.
CHULAKOV Kirill Viktorovich – Head of the Department of Anesthesiology, Resuscitation and Intensive Care with the course of Emergency Medicine
БУЛАТОВ Алквиад Валентинович – к.м.н., доцент
BULATOV Alkviad Valentinovich – MD, Associated Professor, Department of Anesthesiology, Reanimation and Intensive Care with a course of Emergency Medicine, Faculty of Postgraduate Training of Doctors
Проведен анализ медицинской эвакуации больных с тяжелым течением новой коронавирусной инфекции COVID-19 и результатов их лечения в специализированном отделении анестезиологии, реанимации и интенсивной терапии Республики Саха (Якутия). Выполнен сравнительный анализ исходов лечения пациентов с COVID-19-ассоциированной пневмонией из г. Якутска и пациентов, доставленных из центральных районных больниц санитарной авиацией. Установлено, что пациенты, эвакуированные из сельских районов, отличались более молодым возрастом, высоким индексом массы тела и большим объемом поражения легочной ткани. У городских пациентов чаще наблюдались церебральная недостаточность, острое повреждение почек и развитие полиорганной недостаточности. Статистически значимой разницы летальных исходов между городскими и районными больными с COVID-19-ассоциированной пневмонией не выявлено, что свидетельствует об эффективности организации медицинской эвакуации из центральных районных больниц.
In order to study the timeliness of medical evacuation of the patients with severe novel coronavirus from the districts of the Sakha Republic (Yakutia), a retrospective analysis of data from the Republic’s Center for Disaster Medicine (RCDM) for 2019-2022 was carried out. To compare the treatment results of patients living in the city of Yakutsk and patients evacuated from the districts of the republic (“city”, “district”), we conducted a prospective observational case-control study of 600 patients with severe COVID-19 in the specialized anesthesiology, resuscitation and intensive care unit (ARICU) of the Sakha Republic Clinical Hospital in 2020-2022. Lethal outcome (n=397) was chosen as the studied criterion. It was found that the study groups had statistically significant differences in age (p=0.002), body mass index (BMI) (p=0.001), saturation (SaO2) of mixed blood upon admission to the ARICU (p=0.003), oxygenation index (p=0.011), and the severity of the condition according to the SOFA (Sequential Organ Failure Assessment) score. The patients evacuated from the districts were characterized by younger age, higher body mass index, and greater damage to lung tissue. City residents were more prone to experience brain failure, acute kidney injury, and the development of multiple organ dysfunction. The mortality rate for the district patients with severe COVID-associated community-acquired pneumonia was 65.8%; for urban patients it made 66.3%, with no statistically significant differences established (p=0.906). Thus, the arrangement of medical evacuation for COVID-19 patients to a specialized institution during the pandemic ensured the availability and timeliness of specialized care provided to them.
The authors declare that there are no conflicts of interest present.