Öz

Amaç

Kritik Koronavirüs hastalığı-2019 (COVID-2019) hastalarında hastalığın şiddetinin erken biyobelirteçler ile belirlenmesi tedaviyi kolaylaştırabilir ve mortaliteyi azaltabilir. Bu retrospektif gözlemsel çalışmada, farklı enflamatuvar indekslerin COVID-19 hastalarında mortaliteyi tahmin etmedeki rollerini belirlemek amaçlandı.

Gereç ve Yöntem

İnflamatuar parametrelerin [C-reaktif protein (CRP), ferritin, prokalsitonin (PCT)] ve nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı, türetilmiş NLR, sistemik inflamasyon indeksi, CRP-lenfosit oranı (CRP/L), CRP-albümin oranı ve nötrofil-lenfosit-trombosit oranı gibi parametrelerin 30 günlük mortaliteyi öngörmedeki prognostik değerleri, yoğun bakım ünitesine kabul edilen 305 COVID-19 hastasında değerlendirildi.

Bulgular

Bu çalışmada, APACHE skoru, ferritin, PCT ve CRP/L değerleri, hayatta kalamayan hastalarda hayatta kalanlara kıyasla anlamlı derecede daha yüksekti. Diğer inflamatuar indekslerde anlamlı bir fark bulunmadı. ROC eğrisi analizinde, yüksek ferritin düzeyleri (p < 0.001) ve yüksek APACHE skorları (p < 0.001), hastane içi mortalitenin öngörücüleri olarak tanımlandı. Çok değişkenli regresyon analizinde ise yalnızca yüksek ferritin seviyesi mortalite için bağımsız bir risk faktörü olarak belirlendi (p = 0.002).

Sonuç

Yoğun bakımda yatan kritik COVID-19 hastalarında mortaliteyi öngörmede, çalışmamızda incelediğimiz enflamasyon indekslerinin prediktör olmadıkları, enflamasyon ile ilgili olarak sadece yüksek ferritin düzeylerinin mortalite için bağımsız risk faktörü olduğu saptandı.

Anahtar Kelimeler: COVID-19, biyobelirteç, enflamatuvar indeksler, ferritin, mortalite

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Nasıl atıf yapılır?

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Demirel A, Miniksar ÖH. COVID-19 Kritik Hastalarında Yoğun Bakım Mortalitesini Öngörmede Enflamasyon İndekslerinin Rolü. Turk J Intensive Care. 2024;22(4):239-247. https://doi.org/10.4274/tybd.galenos.2023.82621