COVID-19 Tanısı Alıp Yoğun Bakımda Takip Edilen Sürekli Renal Replasman Tedavisi İhtiyacı Olan Hastaların APACHE-II ve SOFA Skoru ile Değerlendirilmesi

Amaç: Dünya Sağlık Örgütü (DSÖ) tarafından Aralık 2019 yılında pandemi ilan edilen COVID-19 salgını sonrası, Mart’ın ikinci haftasından itibaren ülkemizde olgular bildirilmiştir. COVID-19 olgularının %5’inde hastalığın seyri sırasında yoğun bakım ünitesine (YBÜ) yatış ihtiyacı gelişmektedir. Bu çalışma ile YBÜ’de izlediğimiz kritik durumdaki COVID-19 hastalarından sürekli renal replasman (CRRT) tedavisi ihtiyacı olan hastaların mortalite oranlarını APACHE-II ve SOFA skoru ile değerlendirmesi amaçlanmıştır. Gereç ve Yöntemler: Mart–Eylül 2020 arasında Eğitim Araştırma Hastanesinin Anestezi Yoğun Bakım Ünitesine yatırılıp CRRT ihtiyacı olan 13 hasta APACHE-II ve SOFA skorlama sistemi ile değerlendirildi. CRRT uygulamasından önce ve uygulamadan 2 gün sonra APACHE-II ve SOFA skorları kaydedildi. Mortalite açısından skorlama sistemleri kıyaslandı. Bulgular: CRRT öncesi ve sonrası APACHE-II ve SOFA skorlama sitemlerine bakıldığında; CRRT öncesi APACHE-II skorlama sisteminin tahmini ölüm oranın öngörmede daha belirleyici olduğu; fakat CRRT sonrası APACHE-II ve SOFA skorlama sisteminin birbiriyle farkı olmadığı görülmüştür. Hastanede yatış süreleri değerlendirildiğinde APACHE-II ile SOFA skorlama sistemi arasında negatif yönde bir ilişki bulunmuştur. Sonuç: Çalışmamız literatür ile uyumlu olarak erkeklerde ve hipertansiyonu olan hastalarda mortalitenin daha yüksek olduğunu göstermiştir. Ayrıca APACHE-II ve SOFA skoru arasında CRRT sonrasında mortalite açısından fark olmadığını her iki sisteminde kullanılabileceğini gösterilmiştir. Bu sonuçların gelecekteki takip ve tedavi yöntemlerine katkı sağlayabileceği düşünülmekle birlikte yeni çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

CCRT, , APACHE-II, , SOFA SKORU, COVİD 19

Evaluation of Patients Diagnosed with COVID-19 and Followed up in Intensive Care Unit Requiring Continuous Renal Replacement Therapy Using APACHE-II and SOFA Scores

Objective: In 5% of COVID-19 cases, the requirement for intensive care unit (ICU) hospitalization develops through the disease course. This study aimed to evaluate the mortality rates of the critically ill COVID-19 patients followed up in the ICU who needed continuous renal replacement (CRRT) treatment using APACHE-II and SOFA scores. Materials and Methods: With the APACHE 2 and SOFA Scoring System, 13 patients hospitalized in the Anesthesia Intensive Care Unit of the Education Research Hospital between March and September 2020 and required CRRT were evaluated. APACHE-II and SOFA scores were recorded before and two days after the CRRT application. Scoring systems were compared in terms of mortality. Results: Considering the APACHE-II and SOFA scoring systems before and after CRRT, it was determined that the APACHE-II scoring system before CRRT was more determinant in predicting the estimated mortality rate. However, after CRRT, it was observed that APACHE-II and SOFA scoring systems were not different from each other. When the duration of hospitalization was evaluated, a negative correlation was found between APACHE-II and SOFA scoring systems. Conclusion: Our study concluded that mortality was higher in men and patients with hypertension, consistent with the literature. Our study revealed no difference in mortality between APACHE-II and SOFA scores after CRRT and that both systems could be used. Although it is thought that these results may contribute to future follow-up and treatment methods, new studies are needed.

Keywords:

CRRT, APACHE-II, SOFA Score, COVID-19,

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