COVID-19'lu Yaşlı Bireylerde Başlangıçtaki Hasta Özelliklerinin Kısa ve Uzun Dönem Genel Mortalite Üzerindeki Etkisi: Retrospektif Kohort Çalışması

Year 2024, , 83 - 92, 31.08.2024

Özge Aydın Güçlü , Nilüfer Aylin Acet-öztürk , Dilara Ömer Topçu , Orkun Eray Terzi , Uğur Önal , Ezgi Demirdöğen , Asli Gorek Dilektasli , Dane Ediger , Funda Coşkun , Ahmet Ursavaş , Esra Uzaslan , Halis Akalın , Mehmet Karadağ

https://doi.org/10.47141/geriatrik.1460339

Abstract

Amaç: Yaşlı insanlar yaşlanma ve altta yatan potansiyel sağlık koşullarına bağlı olarak ortaya çıkan fizyolojik değişiklikler nedeniyle daha sık COVID-19 ile karşılaşmaktadır. Çalışmamızda pandemi polikliniğine başvuran, genç-yaşlı, orta-yaşlı ve ileri-yaşlı olarak sınıflandırılan 65 yaş ve üzeri yaşlı hastalarda hastaneye başvuru semptom ve bulgularının kısa ve uzun vadeli mortalite üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Acil servise başvuran semptomatik hastalar çalışmaya dahil edildi. Başvuru anında demografik veriler, semptomlar, komorbiditeler, toraks bilgisayarlı tomografi (BT) ve laboratuvar bulguları kaydedildi. Primer sonlanım noktası tüm nedenlere bağlı kısa dönem (altı ay içinde) ve uzun dönem (dört yıl içinde) ölümlerdi.

Bulgular: Araştırmaya yaş ortalaması 67,4±9,8 yıl olan ve %52,2’si erkek olan 393 hasta dahil edilmiştir. Son dört yıldaki ölüm oranlarına bakıldığında kısa dönemde 72 (%18,3) vakanın, uzun dönemde ise 104 (%26,5) vakanın öldüğü belirlendi. Kronik böbrek yetmezliği (KBY), koroner arter hastalığı (KAH), orta-yaşlı ve ileri-yaşlı hastaların 50-64 yaş grubuyla karşılaştırıldığında genel kısa dönem mortalitenin bağımsız belirleyicileri olduğu bulundu. Erkek cinsiyet, KAH, malignite, KBY, ateş ve nefes darlığı semptomları ile 50-64 yaş grubu ile karşılaştırıldığında genç-yaşlı, orta-yaşlı ve ileri-yaşlı olguların genel uzun dönem mortaliteyi bağımsız olarak öngördüğü belirlendi.

Sonuç: İleri yaş, erkek cinsiyet, nefes darlığı ve ateş semptomları, yüksek D-dimer düzeyleri, KAH, malignite ve KBY varlığı yaşlılarda daha yüksek COVID-19 enfeksiyonu kısa ve uzun dönem ölüm riski ile ilişkiliydi.

Keywords

Yaşlı Hasta, COVID-19, Laboratuvar, Radyoloji, Semptomlar, Mortalite

Impact of Baseline Patient Characteristics on Short- and Long-Term Overall Mortality in Elderly Patients with COVID-19: A Retrospective Cohort Study

Abstract

Aim: Elderly people encounter COVID-19 more frequently due to physiological changes associated with aging and underlying potential health conditions.The study aims to evaluate the impact of baseline patient characteristics on short- and long-term mortality in elderly patients aged 65 and over, classified as youngest-old, middle-aged, or oldest-old, who applied to the pandemic outpatient clinic and had not yet been vaccinated.

Materials and Methods: Symptomatic patients who attended the emergency department were enrolled in the study. Demographic data, symptoms, comorbidities, thoracic computed tomography (CT), and laboratory results were recorded at admission. The primary outcomes were all-cause short-term (within six months) and long-term (within four years) mortality.

Results: The study consists of 393 participants, with a mean age of 67.4 ± 9.8 years and 52.2% male. Considering the death rates in the last four years, it was determined that 72 (18.3%) cases died in the short term, and 104 (26.5%) cases died in the long term. It was found that chronic renal failure (CRF), coronary artery disease (CAD), middle-old and oldest-old-aged patients compared to the 50-64 age group were independent predictors of overall short-term mortality. It was determined that the following factors independently predicted overall long-term mortality: male gender, CAD, malignancy, CRF, fever, and dyspnea symptoms, and the patients of the youngest-old, middle-old, and oldest-old relative to the 50–64 age group.

Conclusion: Advanced age, male gender, symptoms of shortness of breath and fever, high D-dimer levels, the presence of CAD, malignancy, and CRF were related to a higher risk of death from COVID-19 infection in the elderly.

Keywords

Elderly Patients, COVID-19, Laboratory, Radiology, Symptoms, Mortality

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