Covid-19 Hastalarının Kan Gazı Ölçümleri ve Hematolojik Manifestasyonlarının Mortalite ile İlişkisi: Retrospektif Analiz

Yıl 2022, Cilt: 17 Sayı: 2, 83 - 89, 15.07.2022

Refika Kılıçkaya , Yavuz Orak , Filiz Orak , Adem Doğaner

https://doi.org/10.17517/ksutfd.1099333

Öz

Amaç: Amacımız, COVİD-19’lu hastaların yoğun bakım ünitesine yatış ve sonrası dönemde kan gazı ve tam kan sayımı parametrelerinin mortalite ile ilişkilerini araştırmaktır.
Gereç ve Yöntemler: Hastalar grup yaşamayan ve grup yaşayan olarak iki gruba ayrıldı. Hematolojik parametreler 1, 3, 5. gün kaydedildi.
Bulgular: Yüz kırk iki hasta retrospektif olarak analiz edildi. Bunların 46’sı (%32) kadındı. 71 hasta (%50) yaşamayan gruptaydı. Yaşamayan grupta ortalama yaş 61, yaşayan grupta ortalama yaş 60’tı. Noninvaziv ventilasyon günü ve invaziv ventilasyon günü yaşamayan grupta daha yüksekti. Yaşamayan grupta yoğun bakıma yatışta, 3.günde ve 5.günde PO2/FiO2 (p<0.001), lenfosit sayısı (p<0.001), monosit sayısı (p<0.010) ve eozinofil yüzdesi (p<0.025) daha düşük iken nötrofil-lenfosit oranı daha yüksekti (p<0.001). Yoğun bakım yatışta ve üçüncü günde trombosit-lenfosit oranı yaşamayan grupta yaşayan gruptan daha yüksekti (p<0.020). Yoğun bakıma yatışta, 3.gün ve 5.günde, sistemik immün-inflamasyon indeksi yaşamayan grupta yaşayan gruptan daha yüksekti (p<0.011). PO2/FiO2, hematokrit, monosit yüzdesi, eozinofil sayısının mortalite üzerinde etkili olduğu bulundu. Monosit yüzdesindeki azalma, ölüm olasılığını 1.6 kat artırdı.
Sonuç: Kan gazı ve tam kan sayımı parametrelerindeki değişiklikler COVİD-19 hastalarında mortaliteyi etkiledi. Bu çalışma mortalite ile ilgili öngörü sağlayarak, daha etkin tedavi stratejisi geliştirilmesine yol açabilir.

Anahtar Kelimeler

COVID-19, Hematolojik parametreler, Mortalite, Yoğun bakım ünitesi

Relationship of Blood Gas Measurements and Hematological Manifestations of COVID-19 Patients with Mortality: Retrospective Analysis

Öz

Objective: The aim was to investigate the relationship between blood gas and complete blood count parameters and mortality in patients with COVID-19 during and after in the intensive care unit (ICU).
Material and Methods: Patients were divided as group nonsurvivor and group survivor. Hematological parameters were registered on the day 1, 3, 5.
Results: A total of 142 patients were analyzed retrospectively in the study. Out of them, 46 were women (32%). Seventy-one patients were in group nonsurvivor (50%). The median age of group nonsurvivor patients was 61 years, and the median age of group survivor patients was 60 years. Noninvasive ventilation day and mechanical ventilation day were higher in group nonsurvivor. In group nonsurviver, at the admission to the ICU, in the third day and in the fifth day of ICU, PO2/FiO2 (p<0.001), the lymphocyte count (p<0.001), the monocyte count (p<0.010) and the eosinophil percentages (p<0.025) were lower while the neutrophil-lymphocyte ratio was higher (p<0.001) compared to group survivor. At the admission and in third day of ICU, platelet–lymphocyte ratio were higher in group nonsurvivor than group survivor (p<0.020). At the admission, in the third and the fifth day of ICU, systemic immune-inflammation index were
higher in group nonsurvivor than group survivor (p<0.011). The effects of PO2/FiO2, hematocrit, monocyte percentage, eosinophil count on mortality were found to be significant. The decrease in monocyte percentage increased the probability of mortality 1.6 times.
Conclusion: Changes in blood gas and complete blood count parameters affected the mortality in COVID-19 patients. This study may lead to the development of a more effective treatment strategy by providing a prediction about mortality.

Anahtar Kelimeler

COVID-19, Hematological parameters, Mortality, Intensive care unit

Kaynakça

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