Yoğun Bakım Ünitesinde Yatan COVID-19 Hastalarında Mortalitenin Belirgin Bir Belirleyicisi Olarak D-Dimer/Fibrinojen Oranı

Abstract

Amaç: Bu retrospektif kohort çalışmada komorbidite varlığı üzerinden herhangi bir kısıtlama olmaksızın D-dimer/fibrinojen oranının COVID-19'da bir belirleyici olarak değerlendirilmesi amaçlandı. Araçlar ve Yöntem: Yoğun bakım ünitesine kabul edilen hastalarla retrospektif kohort çalışması yapıldı. Demografik veriler (cinsiyet, yaş, vücut kitle indeksi, komorbiditeler), prognostik klinik skorlar, sıralı organ yetmezliği değerlendirme (SOFA) skoru ve Glasgow Koma Skalası (GKS) skorları, Yoğun bakımda yatan hastaların laboratuvar sonuçları ve invazif mekanik ventilasyon (İMV) ihtiyacı ve süresi kaydedildi. Bulgular: Kronik böbrek hastalıkları, akut böbrek yetmezliği, kalp hastalıkları ve şiddetli sepsis, çıkış grubunda anlamlı olarak daha yüksekti. Daha düşük lenfosit seviyelerinin artan ölüm oranıyla ilişkili olduğu bulunmuştur. Ayrıca nötrofil/lenfosit oranı (NLR) ve nötrofiller artan mortaliteyle ilişkiliydi. Daha yüksek D-dimer/fibrinojen oranı (DDFR) mortalite için bir risk faktörüydü, ancak yoğun bakım ünitesinde yatış süresi için bir risk faktörü değildi. Sonuç: DDFR'nin, COVID-19'da hastane içi mortaliteyi öngörmede potansiyel bir etkisi vardır.

Keywords

• COVID-19
• doğuştan gelen inflamatuar yanıt
• kan pıhtılaşması
• ölüm oranı

D-Dimer/Fibrinogen Ratio as a Prominent Predictor of Mortality in COVID-19 Patients Admitted To the Intensive Care Unit

Abstract

Purpose: In this retrospective cohort study, evaluating the role of the D-dimer/fibrinogen ratio in predicting the in-hospital mortality rate of COVID-19 regardless of the presence of comorbidities was aimed. Materials and Methods: This retrospective cohort study included patients admitted to the intensive care unit. The demographic data of the patients (sex, age, body mass index, comorbidities), their prognostic clinical scores, laboratory results, and need for and duration of invasive mechanical ventilation (IMV) were recorded. Results: The rates of chronic renal diseases, acute renal failure, cardiac diseases, and severe sepsis were significantly higher in the exitus group. It was found that lower levels of lymphocytes were associated with increased mortality. Furthermore, neutrophil counts and the neutrophil to lymphocyte ratio (NLR) were associated with increased mortality. A higher D-dimer/fibrinogen ratio (DDFR) was a predictor of mortality but not a predictor of the duration of hospitalization in the ICU. Conclusion: DDFR has a potential impact in anticipating mortality rates in COVID-19 patients.

Keywords

• COVID-19
• blood coagulation
• innate inflammatory response
• mortality rate

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