Which factors are predicting the mortality in patients with COVID-19 in the intensive care unit?

Yıl 2023, Cilt: 4 Sayı: 4, 368 - 372, 30.08.2023

Ümit Murat Parpucu , Sema Turan , Hayriye Cankar Dal , Damla Tosun , Kudret Yasemin Yalnız , Semih Aydemir , Dilek Öztürk Kazancı

https://doi.org/10.47582/jompac.1333211

Öz

Aims: COVID-19 infection is a global health problem; clinical and laboratory parameters have been developed to predict this disease-related mortality/morbidity. Some of these parameters are clinical parameters, while some are laboratory parameters. This study aims to determine whether Acute Physiology and Chronic Health Evaluation (APACHE) II, Glasgow Coma Scale (GCS), age, presence of comorbidity, and absolute lymphocyte count effectively predict mortality in patients admitted to intensive care unit (ICU) due to COVID-19.
Methods: We have included 108 PCR-positive COVID-19 patients admitted to the ICU between 1 October and 31 November 2020 in our research. Demographic characteristics of all patients, APACHE II values within the first 24 hours of admission to ICU, the GCS, the presence of comorbidity, lymphocyte count during ICU admission, duration of ICU stay, and the mortality rates were recorded.
Results: The average age of 108 individuals evaluated in the study was 67±13.61 years, and 56.5% of the patient group consisted of the geriatric age range. Seventy (64.8%) of the patients were female, eighty-nine (82.4%) patients had at least one comorbidity. In the multivariate analysis, it was determined that lymphocyte value, APACHE II score, and the presence of any comorbidity are independent prognostic factors for mortality when accepted to ICU.
Conclusion: In our study, we have determined that age, APACHE II value, presence of comorbidity, and baseline lymphocyte counts are independent predictors of mortality.

Anahtar Kelimeler

Mortality, Covid-19, Intensive Care Unit

COVID-19 hastalarında yoğun bakım izleminde mortaliteyi predikte eden faktörler nelerdir?

Öz

Amaç: COVID-19 enfeksiyonu küresel bir sağlık sorunudur; bu hastalığa bağlı mortalite/morbiditeyi tahmin etmek için klinik ve laboratuvar parametreleri geliştirilmiştir. Bu parametrelerin bir kısmı klinik parametreler iken bir kısmı da laboratuvar parametreleridir. Bu çalışma, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi (APACHE) II, Glasgow Koma Skalası (GKS), yaş, komorbidite varlığı ve mutlak lenfosit sayısının COVID-19 nedeniyle yoğun bakım ünitesine (YBÜ) başvuran hastalarda mortaliteyi etkili bir şekilde tahmin edip etmediğini belirlemeyi amaçlamaktadır.
Gereç-yöntem: Araştırmamıza 1 Ekim – 31 Kasım 2020 tarihleri arasında yoğun bakım ünitesine yatırılan PCR pozitif 108 COVID-19 hastasını dahil ettik. Tüm hastaların demografik özellikleri, yoğun bakıma yatıştan sonraki ilk 24 saat içindeki APACHE II değerleri, GKS, ek hastalık varlığı, yoğun bakıma yatış sırasındaki lenfosit sayısı, yoğun bakımda kalış süresi ve ölüm oranları kaydedildi.
Bulgular: Çalışmada değerlendirilen 108 kişinin yaş ortalaması 67±13,61 idi ve hasta grubunun %56,5'i geriatrik yaş aralığındaydı. Hastaların 70'i (%64,8) kadındı, 89'unda (%82,4) en az bir ek hastalık vardı. Çok değişkenli analizde lenfosit değeri, APACHE II skoru ve herhangi bir komorbiditenin varlığının YBÜ'ye kabul edildiğinde mortalite için bağımsız prognostik faktörler olduğu belirlendi.
Sonuç: Çalışmamızda; yaş, APACHE II değeri, komorbidite varlığı ve başlangıçtaki lenfosit sayılarının mortalitenin bağımsız belirleyicileri olduğunu belirledik.

Anahtar Kelimeler

Mortalite, Covid-19, Yoğun Bakım Ünitesi

Kaynakça

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