The association between potential predictors and death of patients during the COVID-19 pandemic in Shiraz: a hierarchical multiple regression analysis.

INTRODUCTION: Identifying clinical factors that increase the risk of mortality in COVID-19 patients is crucial. This enables targeted screening, optimizing treatment, and prevention of severe complications, ultimately reducing death rates. This study aimed to develop prediction models for the death of patients (i.e., survival or death) during the COVID-19 pandemic in Shiraz, exploring the main influencing factors. METHOD: We conducted a retrospective cohort study using hospital-based records of 1030 individuals diagnosed with COVID-19, who were hospitalized for treatment between March 21, 2021, and March 21, 2022, in Shiraz, Iran. Variables related to the final outcome were selected based on criteria and univariate logistic regression. Hierarchical multiple logistic regression and classification and regression tree (CART) models were utilized to explore the relationships between potential influencing factors and the final outcome. Additionally, methods were employed to identify the high-risk population for increased mortality rates during COVID-19. Finally, accuracy was evaluated the performance of the models, with the area under the receiver operator characteristic curve(AUC), sensitivity, and specificity metrics. RESULTS: In this study, 558 (54.2%) individuals infected with COVID-19 died. The final model showed that the type of medicine antiviral (OR: 11.10, p = 0.038) than reference (antiviral and corticosteroid), and discharge oxygen saturation(O2) (OR: 1.10, p < 0.001) had a positive association with the chance of survival, but other variables were not considered as predictive variables. Predictive models for the final outcome(death) achieved accuracies ranging from 81 to 87% for hierarchical multiple logistic regression and from 87 to 94% for the CART model. Therefore, the CART model performed better than the hirerical multiple logistic regression model. CONCLUSION: These findings firstly elucidate the incidence and associated factors of the outcome (death) among patients in Shiraz, Iran. Furthermore, we demonstrated that antiviral medication alone (without corticosteroids) and high O2 increase the survival chances of COVID patients.

A comparison between the effects of simulation of basic CPR training and workshops on firefighters' knowledge and skills: experimental study.

BACKGROUND: One of the most common causes of death worldwide is cardiopulmonary arrest. Firefighters are among the first responders at the scenes of accidents and can, therefore, play a key part in performing basic cardiopulmonary resuscitation (CPR) for victims who need it. The present study was conducted to compare the effects of simulation training against workshops on the CPR knowledge and skills of firefighters in the south of Iran. METHODS: This experimental (Interventional) study was conducted on 60 firefighters of south of Fars province, Iran. The study was undertaken from March to July 2023. Through random allocation, the participants were divided into two groups: simulation-based training (30 members) and traditional workshop training (30 members). The participants' CPR knowledge and practical skills were measured before, immediately after, and three months after intervention. RESULTS: The findings of the study revealed a statistically significant difference between the pretest and posttest CPR knowledge and skill mean scores of the simulation groups as compared to the workshop group (p < 0.001). As measured three months after the intervention, the firefighters' knowledge and skill mean scores were still significantly different from their pretest mean scores (p < 0.001); however, they had declined, which can be attributed to the fact that the study population did not frequently exercise CPR. CONCLUSION: Based on the findings of the study, even though both methods of education were effective on enhancing the firefighters' CPR knowledge and skill, simulation training had a far greater impact than training in workshops. In view of the decline in the participants' knowledge and skill scores over time, it is recommended that short simulation training courses on CPR should be repeated on a regular basis.