Determinants of Hospitalization and Mortality in COVID-19 Patients Admitted to the Emergency Department

Year 2025, Volume: 35 Issue: 4, 586 - 596, 29.08.2025

Çağrı Bayrak , Yusuf Ertuğrul Aslan , Fatih Ulu , Nurullah Günay

https://doi.org/10.54005/geneltip.1611379

Abstract

Aims: We aim to elucidate the clinical traits, comorbidities, and prognostic factors associated with intensive care unit (ICU) admission and in-hospital mortality in a group of COVID-19 patients admitted to a university hospital.
Methods: This study was conducted in the XXX University Hospital. Retrospective cohort study of patients admitted to the Emergency Department between April 1, 2020, to October 30, 2020, and received the International Classification of Diseases (ICD)-10 diagnostic code of COVID-19. We separated the patients into three groups: outpatients, patients admitted to COVID-19 wards, and patients admitted to ICUs. We performed multivariate regression analyses to identify the variables predicting hospital mortality.
Results: Of the 194 patients included in the study, 54.6% were male, and the median age was 49 (interquartile range, 37–63). The study admitted 128 (66%) patients to wards, 37 (19.1%) to ICUs, and 29 (14.9%) as outpatients. The most frequent comorbidities were hypertension (25.3%), diabetes mellitus (19.1%), and malignancy (11.9%). Compared with the non-ICU group, ICU patients had older ages (p < 0.001) and had more comorbidities. In the multivariate analysis, age (odds ratio [OR], 1.13; 95% confidence interval [CI]: 1.00–1.29), ferritin (OR, 1.004; 95% CI: 1.000–1.008), and red cell distribution width (RDW) (OR, 2.08; 95% CI: 1.18–3.68) on admission were significant factors predicting mortality in the hospital.
Conclusions: In-hospital mortality rate was 16.5% among all patients. The older age, increased ferritin, and RDW are the most important factors associated with a higher risk of death during hospital stays for COVID-19.

Keywords

COVID-19 , critical care , emergency department , intensive care unit , mortality

Acil Servise Başvuran Covid-19 Hastalarında Hastaneye Yatış ve Mortalitenin Belirleyicileri

Abstract

Amaç: Bir üniversite hastanesine başvuran COVID-19 hastaları ile ilgili klinik özellikleri, komorbiditeleri ve prognostik değişkenleri, yoğun bakım ünitesine (YBÜ) yatışı ve hastane içi mortaliteyi öngören faktörleri tanımlamak.
Gereç ve Yöntem: Bu çalışma XXX Üniversitesi Hastanesi'nde yapılmıştır. 1 Nisan 2020 ile 30 Ekim 2020 tarihleri arasında Acil Servise başvuran ve COVID-19 tanı kodunu alan hastaların retrospektif kohort çalışmasıdır. Hastalar; ayaktan hastalar, COVID-19 servislerine yatan hastalar ve YBÜ’ye yatan hastalar olarak üç gruba ayrıldı. Hastanede mortaliteyi öngören değişkenleri belirlemek için çok değişkenli regresyon analizleri yapıldı.
Bulgular: Çalışmaya dahil edilen 194 hastanın %54,6'sı erkekti ve medyan yaş 49'du (çeyrekler arası aralık, 37-63). Hastaların 128'i (%66) servise, 37'si (%19,1) YBÜ’ye yatırıldı, 29'u (%14,9) ayaktan tedavi edildi. En sık eşlik eden hastalıklar hipertansiyon (%25,3), diabetes mellitus (%19,1) malignite (%11,9) idi. Yoğun bakımda olmayan grupla karşılaştırıldığında, yoğun bakım hastalarının yaşı daha büyüktü (p<0,001); ve daha fazla yandaş hastalığı vardı. Çok değişkenli analizde yaş (Odds oranı, 1,13; %95 güven aralığı: 1,00–1,29), ferritin (Odds oranı, 1,004; %95 güven aralığı: 1,000–1,008) ve kırmızı hücre dağılım genişliği (RDW) (Odds oranı, 2.08; %95 güven aralığı: 1.18–3.68) hastanedeki mortaliteyi öngören önemli faktörlerdi.
Sonuç: Tüm hastalarda hastane içi mortalite oranı %16.5 idi. İleri yaş, artan ferritin ve RDW, COVID-19 nedeniyle hastanede kalış sırasında daha yüksek ölüm riski ile ilişkili en önemli faktörlerdir.

Keywords

COVID-19 , kritik bakım , acil servis , yoğun bakım ünitesi , mortalite

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