Acil Servise Başvuran COVİD-19 Pnömonili Hastalarda SOFA, qSOFA, CURB-65 ve 4C Mortalite Skorlama Sistemlerinin Prognostik Değeri

Yıl 2024, , 165 - 171, 30.12.2024

Yasin Ceylan , Metin Yadigaroğlu , Metin Ocak , Murat Güzel , Vecdi Vahdet Çömez , Alper Yaşar , Şakir Hakan Aksu , Murat Yücel

https://doi.org/10.54996/anatolianjem.1466183

Öz

Amaç: Bu çalışmada amacımız acil servise başvuran COVID-19 hastalarında; CURB-65, SOFA, qSOFA ve 4C mortalite skorlarının mortalite ile ilişkisini araştırmaktır.

Gereç ve Yöntemler: Bu prospektif gözlemsel çalışmaya; acil servise başvuran, COVID-19 PCR testi pozitif olan ve torax BT’de pnomoni saptanan hastalar dahil edildi.

Bulgular: Çalışmaya 81’i (%50,6) kadın 160 hasta dahil edildi. Hastalar 30 günlük mortalite durumları bakımından incelendiğinde 50 (%32,3) hastanın öldüğü görüldü. SOFA skoruna göre 0-1 puan alan hastaların 2 (%9,1)’sinde, 2-3 puan alan hastaların 13 (%17,8)’ünde, 4-5 puan alan hastaların 9(%32,1)’unda, 6-7 puan alan hastaların 14 (%66,7)’ünde, 8-9 puan alan hastaların 9 (%75)’unda, 10-11 puan alan hastaların (%66,7)’inde ve 12-14 puan alan olan 1 hastada (%100 mortalite geliştiği görüldü. qSOFA skoruna göre; 0 puan alan hastaların 2 (%10)’inde, 1 puan olan hastaların 7 (%13)’sinde, 2 puan alan hastaların 25 (%42,4)’inde, 3 puan alan hastaların 16 (%59,3)’ında mortalite geliştiği görüldü. CURB-65 skoruna göre; 0-1 puan alan hastaların 4 (%19)’ünde, 2 puan alan hastalardan 5 (%9,1)’inde, 3 ve daha fazla puan alan hastalardan 41 (%48,8)’inde mortalite geliştiği görüldü. 4C mortalite skoruna göre; 0-3 puan alan 5 hastada mortalite
gelişmezken, 4-8 puan alanların 1 (%5,3)’inde,9-14 puana alan hastaların 11 (%19,6)’inde, geri kalan hastaların 38 (%47,5)’inde mortalite gelişti. SOFA, qSOFA, CURB-65 ve 4-C Mortalite skorları ile mortalite arasında istatistiksel olarak anlamlı ilişki tespit edildi (hepsi için p<0,001).

Sonuç: COVID-19 hastalarında; SOFA, qSOFA, CURB-65 ve 4CMortalite skorları ölen hastalarda anlamlı derecede yüksek tespit edildi.

Anahtar Kelimeler

COVİD-19, SOFA, qSOFA, CURB-65, 4C-mortalite, prognoz

The Prognostic Value of SOFA, qSOFA, CURB-65 and 4C Mortality Scoring Systems in COVID-19 Pneumonia Patients Presenting to the Emergency Department

Öz

Aim: The aim of this study is to investigate the relationship between mortality and CURB-65, SOFA, qSOFA, and 4C mortality scores in COVID-19 patients presenting to the emergency department.

Material and Methods: This prospective observational study included patients presenting to the emergency department who tested positive for COVID-19 PCR and were diagnosed with pneumonia on chest CT.

Results: A total of 160 patients, of whom 81 (50.6%) were female, were included in the study. Examination of patient mortality within 30 days revealed that 50 (32.3%) patients died. According to the SOFA score, mortality was observed in 2 (9.1%) of patients with scores of 0-1, 13 (17.8%) of those with scores of 2-3, 9(32.1%) of those with scores of 4-5, 14 (66.7%) of those with scores of 6-7, 9 (75%) of those with scores of 8-9, 1 (66.7%) of those with scores of 10-11, and in 1 patient (100%) with a score of 12-14. According to the qSOFA score, mortality was observed in 2 (10%) of patients with a score of 0, 7 (13%) with a score of 1, 25 (42.4%) with a score of 2, and 16 (59.3%) with a score of 3. According to the CURB-65 score, mortality was observed in 4 (19%) of patients with scores of 0-1, 5 (9.1%) of those with a score of 2, and 41 (48.8%) of those with scores of 3 or higher. Regarding the 4C mortality score, mortality was not observed in any of the 5 patients with scores of 0-3, while mortality occurred in 1 (5.3%) of those with scores of 48, 11 (19.6%) of those with scores of 9-14, and in 38 (47.5%) of the remaining patients. Statistically significant relationships were found between SOFA, qSOFA, CURB-65, and 4C mortality scores and mortality (p<0.001 for all).

Conclusion: In COVID-19 patients, SOFA, qSOFA, CURB-65, and 4C mortality scores were significantly higher in deceased patients.

Anahtar Kelimeler

COVID-19, SOFA, qSOFA, CURB-65, 4C-mortality, prognosis

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