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  • Küçük Resim
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    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
    (Aves, 2021) Gundogan, Kursat; Akbudak, Ismail Hakki; Hanci, Pervin; Halacli, Burcin; Temel, Sahin; Gullu, Zuhal; Yuksel, Recep Civan
    Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. 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/FiO(2) 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.
  • Küçük Resim Yok
    Öğe
    HYPOPHOSPHATEMIA: UNRAVELING A LETHAL CONNECTION WITH ICU MORTALITY IN CRITICALLY ILL COVID-19 PATIENTS: A MULTICENTER OBSERVATIONAL STUDY
    (Soc Medical Biochemists Serbia, 2025) Temel, Sahin; Hanci, Pervin; Akbudak, Ismail Hakki; Halacli, Burcin; Guven, Goksel; Bilir, Yeliz; Yuksel, Recep Civan
    Background: Despite a lack of sufficient knowledge about the prevalence and impact of hypophosphatemia in critically ill COVID-19 patients, organ dysfunction, adverse clinical outcomes, and increased mortality have been consistently associated with hypophosphatemia across diverse patient populations. This retrospective, observational study aimed to investigate hypophosphatemia (HypoP) frequency and establish the correlation between variations in serum phos-phorus levels and outcomes in critically ill patients with SARS-CoV-2. Methods: The research comprised 205 patients diagnosed with COVID-19 confirmed via RT-PCR. The study included COVID-19 patients who experienced respiratory failure and were in intensive care for more than 24 hours, and their phosphorus values were accurately documented. Clinical parameters, comorbidities, respiratory support require-ments, and laboratory findings were analysed. Results: The study participants had a median age of 64 (IQR: 54-75 years), with hypertension being the most pre-valent chronic disease (46%). During the first three days of intensive care, 33% of the participants received conven-tional oxygen support, whereas 54% required intubation and mechanical ventilation (MV). During this period, hypo-phosphatemia was noted in 25% of patients, with an ICU admission median serum phosphorus level of 1.02 (0.87-1.25) mmol/L. The median duration of stay in the intensive care unit (ICU) was 7 days, significantly extended in patients with hypophosphatemia (p=0.046). Phosphorus levels on the third day of ICU stay were an independent predictor of ICU mortality. (COX, HR=1.48, 95% CI=1.11-1.98, p=0.006) Conclusions: During the first three days of ICU admission, 25% of SARS-CoV-2 critically ill adult patients presented with hypophosphatemia. This condition was found to increase ICU mortality rates and prolong ICU stays. Therefore, it is crucial to monitor serum phosphorus levels in the care of critically ill COVID-19 patients.