COVID-19'da hastane içi mortaliteyi tahmin etmede enflamatuvar temelli parametrelerin ve MELD-XI skorunun 4C mortalite skoru ile karşılaştırılması

Year 2022, , 629 - 637, 30.06.2022

Çaşıt Olgun Çelik , Orçun Çıftcı , Nurtaç Özer , Haldun Müderrisoğlu

https://doi.org/10.17826/cumj.1050872

Cited By: 1

Abstract

Amaç: Bu çalışmada nötrofil/lenfosit oranı (NLR), monosit/lenfosit oranı (MLR), trombosit/lenfosit oranı (PLR) ve C-reaktif protein/lenfosit oranı (CLR), nötrofil /trombosit oranı (NPR), nötrofil/monosit oranı (NMR), CRP/albümin oranı (CAR), BUN/albümin oranı (BAR), MELD-XI skoru gibi enflamatuvar parametrelerin ve 4C mortalite skorunun COVID-19 tanısı olanlarda hastane içi mortalite riskini öngörmedeki rollerini karşılaştırdık.
Gereç ve Yöntem: Haziran 2020 ile Şubat 2021 arasında PCR ile COVID-19 tanısı doğrulanan 18 yaşından büyük toplam 117 hasta, geriye dönük olarak çalışmaya dahil edildi. Hastane içi ölümle ilişkili parametrelerin mortaliteyi bağımsız predikte etmedeki rolleri ve bunların birbirileriyle karşılaştırılmaları için uygun istatistiksel yöntemler yapıldı.
Bulgular: Yaş, diyabetes mellitus, kronik böbrek hastalığı, akut böbrek hasarı ve hastanede yatış süresi, üre, kreatinin, LDH, AST, ferritin, D-dimer, CRP, albümin, Hb, CLR, BAR, CAR, MELD-XI skoru ve 4C mortalite skoru hastane içi mortalite ile anlamlı olarak ilişkili bulundu. Bununla birlikte, sadece 4C mortalite skoru ve AST, COVID-19’da hastane içi mortalitenin bağımsız öngörücüleriydi [4C mortalite skoru için OR 2.08 (%95 GA 1.06-2.36; ve AST için OR 1.05 (%95 GA 1.00- 1.10]..
Sonuç: 4C mortalite skoru ve AST, hastaneye yatırılan COVID-19 hastalarında mortalite ile ilişkili diğer enflamatuvar parametrelerden farklı olarak aynı zamanda mortalitenin bağımsız ve güçlü öngörücüleridir.

Keywords

AST, COVID-19, enflamatuvar parametreler, 4C mortalite skoru, MELD-XI skoru

Supporting Institution

Başkent Üniversitesi Tıp Fakültesi

Project Number

KA21/288

Comparison of inflammation-based parameters and MELD-XI score with 4C mortality score in predicting in-hospital mortality in COVID-19

Abstract

Purpose: In this study, we compared the roles of inflammatory parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein/lymphocyte ratio (CLR), monocyte/lymphocyte ratio (MLR), neutrophil/platelet ratio (NPR), neutrophil/monocyte ratio (NMR), CRP/albumin ratio (CAR), BUN/albumin ratio (BAR), MELD-XI score and 4C mortality score in predicting in-hospital mortality risk in COVID-19.
Materials and Methods: A total of 117 patients over 18 years old with a PCR-confirmed diagnosis of COVID-19 between June 2020 and February 2021 were retrospectively included. The roles of parameters for independently predicting in-hospital mortality were determined and compared with each other using appropriate statistical methods.
Results: Age, chronic kidney disease, diabetes mellitus, acute kidney injury, and length of hospital stay, urea, creatinine, LDH, AST, ferritin, D-dimer, CRP, albumin, Hb, CLR, BAR, CAR, MELD-XI score, and 4C mortality score were significantly correlated to in-hospital mortality. However, only the 4C mortality score and AST independently predicted in-hospital mortality in COVID-19 [OR 2.08 (%95 CI 1.06-2.36), for 4C mortality score, and OR 1.05 (%95 CI 1.00-1.10), for AST].
Conclusion: Unlike other mortality-related inflammatory parameters, the 4C mortality score and AST were independent and strong predictors of mortality in hospitalized COVID-19 patients.

Keywords

AST, COVID-19, inflammatory parameters, 4C mortality score, MELD-XI score

Project Number

KA21/288

References

• WHO (World Health Organization). WHO Coronavirus (COVID-19) dashboard. https://covid19.who.int/(accessed Dec 2021).
• Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24:255.
• Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: a pooled analysis. Am J Emerg Med. 2020;38:1722-6.
• Ullah W, Basyal B, Tariq S, Almas T, Saeed R, Roomi S et al. Lymphocyte-to-C-reactive protein ratio: A novel predictor of adverse outcomes in COVID-19. J Clin Med Res. 2020;12:415-22.
• Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z et al. Multi-organ dysfunction in patients with COVID-19: A systematic review and meta-analysis. Aging Dis. 2020;11:874-94.
• Seyit M, Avcı E, Nar R, Senol H, Yılmaz A, Özen M et al. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med. 2021;40:110-4.
• Ok F, Erdoğan O, Durmuş E, Çarkcı S, Canik A. Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID-19 patients. J Med Virol. 2021;93:786-93.
• Küçükceran K, Ayrancı MK, Girişgin AS, Koçak S, Dündar ZD. The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department. Am J Emerg Med. 2021;48:33-7.
• Becerra-Munoz VM, Nunez-Gil IJ, Eid CM, Aguado MG, Romero R, Huang J et al. Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19. Age Ageing. 2021;50:326-34.
• Pan F, Jang L, Li Y, Liang B, Li L, Ye T et al. Factors associated with death outcome in patients with severe coronavirus disease-19 (COVID-19): a case-control study. Int J Med Sci. 2020;17:1281-92.
• Knight SR, Ho A, Pius R, Buchan I, Carson G, Drake TM et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ. 2020;370:m3339.
• Wernly B, Lichtenauer M, Vellinga N, Boerma C, İnce C, Kelm M et al. Model for End-Stage Liver Disease Excluding INR (MELD-XI) score is associated with hemodynamic impairment and predicts mortality in critically ill patients. Eur J Intern Med. 2018;51:80-4.
• Biegus J, Zymliński R, Sokolski M, Siwolowski S, Gajewski P, Nawrocka-Millward S et al. Impaired hepato-renal function defined by the MELD-XI score as prognosticator in acute heart failure. Eur J Heart Fail. 2016;18:1518-21.
• Adams ED, Jackson NJ, Young T, DePasquale EC, Reardon LC. Prognostic utility of MELD-XI in adult congenital heart disease patients undergoing cardiac transplantation. Clin Transplant. 2018;32:e13257.
• Buburuz AM, Petris A, Costache II, Jelihovschi I, Arsenescu-Georgescu C, Iancu LS. Evaluation of laboratory predictors for in-hospital mortality in infective endocarditis and negative blood culture pattern characteristics. Pathogens. 2021;10:551.
• SJ He, Weng JX, Chen HJ, Li HQ, Guo WQ, Cao Q et al. The prognostic value of MELD-XI in elderly patients with ST-segment elevation myocardial infarction: an observational study. BMC Cardiovasc Disord. 2021;21:53.
• Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.
• Kuroda S, Matsumoto S, Sano T, Kitai T, Yonetsu T, Kohsaka S et al. External validation of the 4C Mortality Score for patients with COVID-19 and pre-existing cardiovascular diseases/risk factors. BMJ Open. 2021;11:e052708.
• Wellbelove Z, Walsh C, Perinpanathan T, Lillie P, Barlow G. Comparing the 4C mortality score for COVID-19 to established scores (CURB65, CRB65, qSOFA, NEWS) for respiratory infection patients. J Infect. 2021;82:414-51.
• Jones A, Pitre T, Junek M, Kapralik J, Patel R, Feng E et al. External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective stud. Sci Rep. 2021;11:18638.
• Yıldız H, Castanares-Zapatero DC, Hannesse C, Vandermeersch D, Pothen L, Yombi JC et al. Prospective validation and comparison of COVID-GRAM, NEWS2, 4C mortality score, CURB-65 for the prediction of critical illness in COVID-19 patients. Infect Dis (Lond). 2021;53:640-2.
• Covino M, Mattes GD, Burzo ML, Russo A, Forte E, Carnicelli A et al. Predicting in‐hospital mortality in COVID‐19 older patients with specifically developed scores. J Am Geriatr Soc. 2021;69:37-43.
• Velissaris D, Parakevas T, Oikonomou E, Bizos A, Karamouzos M, Marangos M. Evaluation of four novel prognostic scores on admission for COVID-19 mortality. An experience from a Mediterranean tertiary center. Acta Clin Belg. 2021;26:1-5.
• Cai Q, Huang D, Yu H, Zhu Z, Xia Z, Su Y et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020;73:566-74.
• Ding ZY, Li GX, Chen L, Shu C, Song J, Wang W et al. Association of liver abnormalities with in-hospital mortality in patients with COVID-19. J Hepatol. 2021;74:1295-302.
• Stawinski PM, Dziadkowiec KN, Al-Abbasi B, Suarez L, Simms L, Dewaswala N et al. Model of End-Stage Liver Disease (MELD) score as a predictor of in-hospital mortality in patients with COVID-19: A novel approach to a classic scoring system. Cureus. 2021;13:e15179.
• Bruno RR, Wernly B, Hornemann J, Flaatten H, FjØlner J, Artigas A et al. Early evaluation of organ failure using MELD-XI in critically ill elderly COVID-19 patients Clin Hemorheol Microcirc. 2021;79:109-20.