Kürşat Gündoğan1, İsmail Hakkı Akbudak2, Pervin Hancı3, Burçin Halaçlı4, Şahin Temel1, Zuhal Güllü5, Kamil İnci5, Yeliz Bilir6, Firdevs Tuğba Bozkurt7, Fatma Yıldırım8, Meltem Şimşek8, Recep Civan Yüksel9, Esma Eren9, Neriman Defne Altıntaş10, Leyla Talan10, Gülseren Elay11, Göksel Güven12, İskender Kara13, Emre Aydın14, Seda Yılmaz15, Tuğçe Mengi16, Sema Sarı16, Türkay Akbaş17, Burcu Acar Cinleti18, Nazire Ateş Ayhan19, Deniz Aral Özbek4, Taha Koray Şahin4, Aslı Açıkgöz13, Ali Ümit Esbah17, Ahmet Fırat19, Ferhan Aydemir20, Mehmet Çağatay Gürkök20, Avşar Zerman21, Ayça Gümüş21, Melda Türkoğlu22, Müge Aydoğdu22, Ramazan Ulu23, Jale Bengi Çelik13, Canan Balcı15, Cenk Kıraklı18, Emre Karakoç19, Ezgi Özyılmaz24, Ebru Ortaç Ersoy4, Serpil Öcal4, İrem Akın Şen3, İbrahim Hakkı Tor3, Bilgin Cömert20, Begüm Ergan25, Kemal Tolga Saraçoğlu6, Jülide Ergil8, Ümmü Gülsüm Yüksel12, Nuri Tutar26, Murat Sungur1, Arzu Topeli4. 1. Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey. 2. Division of Intensive Care Medicine, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey. 3. Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey. 4. Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey. 5. Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey. 6. Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey. 7. Intensive Care Unit, Ministry of Health, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey. 8. Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey. 9. Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey. 10. Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey. 11. Division of Intensive Care Medicine, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey. 12. Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey. 13. Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey. 14. Division of Intensive Care Medicine, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey. 15. Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey. 16. Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey. 17. Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey. 18. Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey. 19. Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey. 20. Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey. 21. Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey. 22. Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey. 23. Division of Intensive Care Medicine, Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey. 24. Division of Intensive Care Medicine, Department of Chest Diseases, Çukurova University School of Medicine, Adana, Turkey. 25. Division of Intensive Care Medicine, Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey. 26. Division of Intensive Care Medicine, Department of Chest Diseases, Erciyes University School of Medicine, Kayseri, Turkey
Abstract
BACKGROUND: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. AIMS: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. STUDY DESIGN: Retrospective, observational cohort. METHODS: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. RESULTS: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). CONCLUSION: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.
BACKGROUND: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. AIMS: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. STUDY DESIGN: Retrospective, observational cohort. METHODS: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. RESULTS: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). CONCLUSION: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.
Authors: Shruti Gupta; Salim S Hayek; Wei Wang; Lili Chan; Kusum S Mathews; Michal L Melamed; Samantha K Brenner; Amanda Leonberg-Yoo; Edward J Schenck; Jared Radbel; Jochen Reiser; Anip Bansal; Anand Srivastava; Yan Zhou; Anne Sutherland; Adam Green; Alexandre M Shehata; Nitender Goyal; Anitha Vijayan; Juan Carlos Q Velez; Shahzad Shaefi; Chirag R Parikh; Justin Arunthamakun; Ambarish M Athavale; Allon N Friedman; Samuel A P Short; Zoe A Kibbelaar; Samah Abu Omar; Andrew J Admon; John P Donnelly; Hayley B Gershengorn; Miguel A Hernán; Matthew W Semler; David E Leaf Journal: JAMA Intern Med Date: 2020-11-01 Impact factor: 21.873
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Authors: Silvio A Ñamendys-Silva; Pedro E Alvarado-Ávila; Guillermo Domínguez-Cherit; Eduardo Rivero-Sigarroa; Luis A Sánchez-Hurtado; Alan Gutiérrez-Villaseñor; Juan P Romero-González; Heber Rodríguez-Bautista; Alondra García-Briones; César E Garnica-Camacho; Néstor G Cruz-Ruiz; María O González-Herrera; Francisco J García-Guillén; Manuel A Guerrero-Gutiérrez; José D Salmerón-González; Laura Romero-Gutiérrez; José L Canto-Castro; Victor H Cervantes Journal: Heart Lung Date: 2020-10-21 Impact factor: 2.210
Authors: Christian Karagiannidis; Carina Mostert; Corinna Hentschker; Thomas Voshaar; Jürgen Malzahn; Gerhard Schillinger; Jürgen Klauber; Uwe Janssens; Gernot Marx; Steffen Weber-Carstens; Stefan Kluge; Michael Pfeifer; Linus Grabenhenrich; Tobias Welte; Reinhard Busse Journal: Lancet Respir Med Date: 2020-07-28 Impact factor: 30.700
Authors: Barbara Bonnesen; Jens-Ulrik Stæhr Jensen; Klaus Nielsen Jeschke; Alexander G Mathioudakis; Alexandru Corlateanu; Ejvind Frausing Hansen; Ulla Møller Weinreich; Ole Hilberg; Pradeesh Sivapalan Journal: Diagnostics (Basel) Date: 2021-12-02