Çaşıt Olgun ÇELİK, Orçun ÇİFCİ, Nurtaç ÖZER, İbrahim Haldun MÜDERRİSOĞLU

COVID-19'da hastane içi mortaliteyi tahmin etmede enflamatuvar temelli parametrelerin ve MELD-XI skorunun 4C mortalite skoru ile karşılaştırılması

Amaç: Bu çalışmada nötrofil/lenfosit oranı (NLR), monosit/lenfosit oranı (MLR), trombosit/lenfosit oranı (PLR) ve C-reaktif protein/lenfosit oranı (CLR), nötrofil /trombosit oranı (NPR), nötrofil/monosit oranı (NMR), CRP/albümin oranı (CAR), BUN/albümin oranı (BAR), MELD-XI skoru gibi enflamatuvar parametrelerin ve 4C mortalite skorunun COVID-19 tanısı olanlarda hastane içi mortalite riskini öngörmedeki rollerini karşılaştırdık. Gereç ve Yöntem: Haziran 2020 ile Şubat 2021 arasında PCR ile COVID-19 tanısı doğrulanan 18 yaşından büyük toplam 117 hasta, geriye dönük olarak çalışmaya dahil edildi. Hastane içi ölümle ilişkili parametrelerin mortaliteyi bağımsız predikte etmedeki rolleri ve bunların birbirileriyle karşılaştırılmaları için uygun istatistiksel yöntemler yapıldı. Bulgular: Yaş, diyabetes mellitus, kronik böbrek hastalığı, akut böbrek hasarı ve hastanede yatış süresi, üre, kreatinin, LDH, AST, ferritin, D-dimer, CRP, albümin, Hb, CLR, BAR, CAR, MELD-XI skoru ve 4C mortalite skoru hastane içi mortalite ile anlamlı olarak ilişkili bulundu. Bununla birlikte, sadece 4C mortalite skoru ve AST, COVID-19’da hastane içi mortalitenin bağımsız öngörücüleriydi [4C mortalite skoru için OR 2.08 (%95 GA 1.06-2.36; ve AST için OR 1.05 (%95 GA 1.00- 1.10].. Sonuç: 4C mortalite skoru ve AST, hastaneye yatırılan COVID-19 hastalarında mortalite ile ilişkili diğer enflamatuvar parametrelerden farklı olarak aynı zamanda mortalitenin bağımsız ve güçlü öngörücüleridir.

Comparison of inflammation-based parameters and MELD-XI score with 4C mortality score in predicting in-hospital mortality in COVID-19

Purpose: In this study, we compared the roles of inflammatory parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein/lymphocyte ratio (CLR), monocyte/lymphocyte ratio (MLR), neutrophil/platelet ratio (NPR), neutrophil/monocyte ratio (NMR), CRP/albumin ratio (CAR), BUN/albumin ratio (BAR), MELD-XI score and 4C mortality score in predicting in-hospital mortality risk in COVID-19. Materials and Methods: A total of 117 patients over 18 years old with a PCR-confirmed diagnosis of COVID-19 between June 2020 and February 2021 were retrospectively included. The roles of parameters for independently predicting in-hospital mortality were determined and compared with each other using appropriate statistical methods. Results: Age, chronic kidney disease, diabetes mellitus, acute kidney injury, and length of hospital stay, urea, creatinine, LDH, AST, ferritin, D-dimer, CRP, albumin, Hb, CLR, BAR, CAR, MELD-XI score, and 4C mortality score were significantly correlated to in-hospital mortality. However, only the 4C mortality score and AST independently predicted in-hospital mortality in COVID-19 [OR 2.08 (%95 CI 1.06-2.36), for 4C mortality score, and OR 1.05 (%95 CI 1.00-1.10), for AST]. Conclusion: Unlike other mortality-related inflammatory parameters, the 4C mortality score and AST were independent and strong predictors of mortality in hospitalized COVID-19 patients.

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