Yoğun Bakımda Yatan Yaşlı COVID-19 Hastalarında Tahmini Glomerüler Filtrasyon Hızının Mortaliteye Etkisi

Amaç: Akut böbrek hasarı(AKI), COVID-19 pnömonisi olan hastalarda bildirilmiştir ve daha yüksek mortalite ile ilişkilidir. Çalışmamızın amacı yaşlı COVID-19 hastalarında yoğun bakıma yatıştaki eGFR ile mortalite ve klinik sonuçlar arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: Yaşlı katılımcıların dahil edildiği bu çalışma, tek merkezli bir yoğun bakım ünitesinde (YBÜ) retrospektif olarak yapıldı. Bulgular: Çalışmaya 75 kadın ve 77 erkek olmak üzere toplam 152 hasta dahil edildi. Hastaların yaş ortalaması 74.3±7.3 yıl idi. eGFR için Evre 1-2’deki hasta sayısı 92 (%60.5), Evre 3a’daki hasta sayısı 15 (%9.9), Evre 3b’deki hasta sayısı 26 (%17.1) ve Evre 4-5’deki hasta sayısı 19’dur (%12.5). İnvaziv mekanik ventilatör uygulanan hastalar %40.8, hastane mortalitesi %48.7 idi. Yapılan multivariate logistic regression analizine göre eGFR, LDH, Charlson skoru ve yoğun bakım yatış süresi mortalite üzerine etkili bulunmuştur. eGFR Evre 1-2’de olan hastalara göre mortalite riski Evre 3a hastalarında 4.836 kat, Evre 3b hastalarında 12.233 kat ve Evre 4-5 hastalarında 10.242 kat fazladır. Sonuç: Bulgularımız, COVID-19 hastalarının yoğun bakım ünitesine başvuru anında eGFR, LDH, Charlson skoru ve yoğun bakım yatış süresi mortalite üzerine etkili bulunmuştur.

Anahtar Kelimeler:

COVID-19, yoğun bakım ünitesi, akut böbrek hasarı, mortalite

The Effect of Estimated Glomerular Filtration Rate on Mortality in the Elderly COVID-19 Patients in the Intensive Care Unit

Objective: Acute kidney injury (AKI) has been reported in patients with COVID-19 pneumonia and associated with higher mortality. Our study aimed to determine the relationship of eGFR during admission to the intensive care unit with mortality and clinical outcomes in the elderly COVID-19 patients. Material and Method: This study in which the elderly patients were included was retrospectively performed in a single-center intensive care unit (ICU). Results: A total of 152 patients including 75 female and 77 male patients were included in the study. Mean age of the patients was 74.3±7.3 years. The number of patients was 92 (60.5%) in eGFR Stage 1-2, 15 (9.9%) in Stage 3a, 26 (17.1%) in Stage 3b, and 19 (12.5%) in Stage 4-5. The rate of patients who received invasive mechanical ventilation was 40.8% and hospital mortality rate was 48.7%. According to the multivariate logistic regression analysis, eGFR, LDH, Charlson score, and duration of stay in the intensive care unit were effective on mortality. Compared to eGFR Stage 1-2 patients, the mortality risk was 4.836 times higher in Stage 3a patients, 12.233 times higher in Stage 3b patients and 10.242 times higher in Stage 4-5 patients. Conclusion: Our results revealed that COVID-19 patients’ eGFR during admission to the intensive care unit, LDH, Charlson score, and duration of stay in the intensive care unit were effective on mortality.

Keywords:

COVID-19, intensive care unit, acute kidney injury, mortality,

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