Evaluation of Risk Factors Affecting Mortality in Patients with the Diagnosis of COVID-19 in the Secondary Intensive Care Unit: A Single Center Retrospective Study

Abstract

Objective: In the early stages of the worldwide coronavirus disease 2019 (COVID-19) pandemic, there aren’t many secondary intensive care unit publications. In our study, it was aimed to calculate the mortality rate and to determine the factors affecting mortality by retrospectively evaluating the data of COVID-19 patients hospitalized in a secondary intensive care unit. Methods: The files and records of patients aged 18 years and older who were positive for reverse transcriptase-polymerase chain reaction and followed in the secondary COVID-19 intensive care unit between January 2020 and July 2021, and their records in the hospital information system, were evaluated retrospectively. Demographic data, laboratory parameters, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and clinical data of the patients were recorded. The data of living and deceased patients were compared. Regression analysis was performed for data with risk factors. Results: Archive records of a total of 227 patients were reviewed. The all cause mortality rate was 53.3%, and the median length of stay in the intensive care unit was 5 years. There was a significant difference in age (p<0.001), need for invasive mechanical ventilation (p<0.001), hospitalization saturation (p=0.016), ferritin (p<0.001), D-Dimer p(<0.001), APACHE II (p<0.001) and SOFA (p<0.001) scores between the living and deceased patient groups. Conclusion: Due to the increased number of patients and workload at the beginning of the COVID-19 pandemic, patient follow-up was carried out under difficult conditions in all intensive care units, especially in the secondary care units. In this period, we think that easily accessible biomarkers that can be used to predict mortality in secondary intensive care units may play a role in planning the treatment and referral processes of patients, and may have positive effects on patient outcomes by using the facilities more efficiently. Keywords: COVID-19, intensive care unit, mortality, risk factor