Pandemi servisinde yatan COVID-19 hastalarının yatış kan değerleri ile prognozlarının öngörülebilirliğinin değerlendirilmesi: Retrospektif bir çalışma

Year 2022, Volume: 3 Issue: 3, 88 - 95, 30.09.2022

Muhammet Kızmaz , Funda Gökgöz Durmaz

https://doi.org/10.55665/troiamedj.1120090

Cited By: 1

Abstract

Amaç: Prognostik öngörücüler, devam eden COVID-19 pandemisi sırasında sağlık sisteminin hızlı tepki vermesi ve optimal kullanımı için önemlidir. COVID-19 hastalarında erken evrelerden başlayarak birçok hematolojik parametrenin bozulabileceği bildirilmiştir. Mevcut çalışma ile serviste takip edilen hastaların hematolojik ve biyokimyasal değerlerinin, yoğun bakım yatışı ve mortalite ile ilişkisinin belirlenmesi amaçlanmıştır. Yöntem: Bu çalışma geriye dönük dosya tarama çalışmasıdır. Hasta grubu 1.09.2021-15.12.2021 tarihleri arasında pandemi servisine yatan hastalardan oluşmaktadır. İlgili tarih aralığında yatan 366 hastanın tamamı değerlendirildi, dışlama kriterleri sonrası 242 hasta çalışmaya alındı. Hastaların tamamının polimeraz zincir reaksiyon testleri pozitifti. Hastaların servise yatışlarının ilk günündeki kan parametreleri, yaş, boy, kilo, cinsiyet, kronik hastalıkları ve steroid tedavisi dosyalarından kaydedilerek incelendi. Servis çıkışlarına göre hastalar, yoğun bakıma devir (yoğun bakım tedavisinden sonra taburcu olanlar), ölüm ile sonuçlanan (servisten yoğun bakıma devredilen ve taburcu olmadan ölenler) ve eve taburcu (hiç yoğun bakım yatışı olmadan servisten eve taburcu olanlar) olarak üç gruba kategorize edildi. Bulgular: Çalışmaya alınan 242 hastanın 135’i (%55.8) kadın, 107’si (44.2%) erkektir. Hastaların 213’ü (%88) servisten eve taburcu edildi, 8’i (%3.3) yoğun bakıma devir edildi ve 21’i (%8.7) ölümle sonuçlandı. Ölümle sonuçlanan hastaların yaş ortalaması (69.6±13.14 yıl), yoğun bakıma devir edilenlerin yaş ortalamasından (61.25±15.75) ve servisten eve taburcu edilen hastaların yaş ortalamasından (68.91±12.97) anlamlı olarak daha büyüktür. Hastalar yaşayan ve ölümle sonuçlanan olarak iki gruba ayrılıp incelenince; yaş, lenfosit, kan üre azotu, glomerüler filtrasyon hızı, aspartat aminotransferaz, albumin, C reaktif protein, prokalsitonin, D-dimer, trombosit lenfosit oranı (TLO) ve nötrofil lenfosit oranı (NLO) değerlerinde iki grup arasında anlamlı farklılık vardı. Anlamlı değerlerle oluşturulan regresyon modeline göre yaş, NLO, D-dimer yüksekliği ve TLO düşüklüğü mortalite için bağımsız risk faktörleri olarak bulunmuştur. Sonuç: Sunulan çalışmada yaş, yatış günü alınan kandan ölçülen D-dimer, TLO ve NLO COVID-19 hastalarında mortalite için bağımsız prognostik belirteçler olarak bulunmuştur.

Keywords

COVID-19, trombosit-lenfosit oranı, nötrofil-lenfosit oranı, hemogramdan türetilen oranlar, biyobelirteçler, hastalık şiddeti

Supporting Institution

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Project Number

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Evaluation of the predictability of prognoses of COVID-19 patients hospitalized in the pandemic service by hospitalization blood values: A retrospective study

Abstract

Objectives: Prognostic predictors are important for the rapid response and optimal use of the health system during the ongoing COVID-19 pandemic. It has been reported that many hematological parameters may deteriorate starting from the early stages in COVID-19 patients. The aim of the present study was to determine the relationship between hematological and biochemical parameters of patients followed in the service, intensive care hospitalization, and mortality. Methods: The present study is a retrospective study. Participants consist of patients hospitalized in the pandemic service between 1.09.2021 and 15.12.2021. All 366 patients hospitalized in the relevant date range were evaluated, and after exclusion criteria, the study was conducted on 242 patients. Polymerase chain reaction tests of all patients were positive. The hematological and biochemical parameters of the patients on the first day of hospitalization, their age, height, weight, gender, chronic diseases, and steroid treatments were recorded. According to service exits, patients were categorized into three groups: transfer to intensive care (discharged after intensive care treatment), resulting in death (transferred from the ward to intensive care unit and died without discharge), and discharged home (discharged home from the ward without intensive care admission). Results: Of the 242 patients included in the study, 135 (55.8%) were female and 107 (44.2%) were male. Of the patients, 213 (88%) were discharged home from the ward, 8 (3.3%) were transferred to the intensive care unit, and 21 (8.7%) died. The mean age of the patients who died (69.6±13.14 years) was significantly higher than of those transferred to the intensive care unit (61.25±15.75) and discharged home from the service (68.91±12.97). When the patients were divided into two groups as survived and dead; age, lymphocyte, blood urea nitrogen, glomerular filtration rate, aspartate aminotransferase, albumin, C reactive protein, procalcitonin, D-dimer, platelet lymphocyte ratio (TLO) and neutrophil lymphocyte Ratio (NLO) values were significantly different between the two groups. According to the regression model created with significant values, age, high NLO and D-dimer, and low TLO were found to be independent risk factors for mortality. Conclusion: In the present study, age, D-dimer, TLO and NLO measured on the day of hospitalization were found to be independent prognostic markers for mortality in COVID-19 patients.

Keywords

COVID-19, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, hemogram-derived-ratios, biomarkers, disease severity, mortality

Project Number

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