Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units.
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Gündoğan Kürşat, Akbudak İsmail Hakkı, Hancı Pervin, Halaçlı Burçin, Temel Şahin, Güllü Zuhal, İnci Kamil, Bilir Yeliz, Bozkurt Firdevs Tuğba, Yıldırım Fatma, Şimşek Meltem, Yüksel Recep Civan, Eren Esma, Altıntaş Neriman Defne, Talan Leyla, Elay Gülseren, Güven Göksel, Kara İskender, Aydın Emre, Yılmaz Seda, Mengi Tuğçe, Sarı Sema, Akbaş Türkay, Acar Cinleti Burcu, Ateş Ayhan Nazire, Aral Özbek Deniz, Şahin Taha Koray, Açıkgöz Aslı, Esbah Ali Ümit, Fırat Ahmet, Aydemir Ferhan, Gürkök Mehmet Çağatay, Zerman Avşar, Gümüş Ayça, Türkoğlu Melda, Aydoğdu Müge, Ulu Ramazan, Çelik Jale Bengi, Balcı Canan, Kıraklı Cenk, Karakoç Emre, Özyılmaz Ezgi, Ortaç Ersoy Ebru, Öcal Serpil, Akın Şen İrem, Tor İbrahim Hakkı, Cömert Bilgin, Ergan Begüm, Saraçoğlu Kemal Tolga, Ergil Jülide, Yüksel Ümmü Gülsüm, Tutar Nuri, Sungur Murat, Topeli Arzu
Аннотация
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.