Chronic critical illness in critically ill COVID-19 patients.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Chronic Illness Pub Date : 2024-03-01 Epub Date: 2023-03-07 DOI:10.1177/17423953231161333

Burcin Halacli, Mehmet Yildirim, Esat Kivanc Kaya, Ege Ulusoydan, Ebru Ortac Ersoy, Arzu Topeli

{"title":"Chronic critical illness in critically ill COVID-19 patients.","authors":"Burcin Halacli, Mehmet Yildirim, Esat Kivanc Kaya, Ege Ulusoydan, Ebru Ortac Ersoy, Arzu Topeli","doi":"10.1177/17423953231161333","DOIUrl":null,"url":null,"abstract":"Objectives: To evaluate the presence of chronic critical illness (CCI) in COVID-19 patients and compare clinical characteristics and prognosis of patients with and without CCI admitted to intensive care unit (ICU).Methods: It was a retrospective, observational study at a university hospital ICU. Patients were accepted as CCI if they had prolonged ICU stay (≥14 days) and got ≥1 score for cardiovascular sequential organ failure assessment (SOFA) score and ≥2 score in other parameters on day 14 of ICU admission which was described as persistent organ dysfunction.Results: 131 of 397 (33%) patients met CCI criteria. CCI patients were older (p = 0.003) and frailer (p < 0.001). Their Acute Physiology and Chronic Health Evaluation (APACHE) II and SOFA scores were higher, PaO2/FiO2 ratio was lower (p < 0.001). Requirement of invasive mechanical ventilation (IMV), steroid use, and septic shock on admission were higher in the CCI group (p < 0.001). CCI patients had higher ICU and hospital mortality than other patients (54.2% vs. 19.9% and 55.7% vs. 22.6%, p < 0.001, respectively). Regression analysis revealed that IMV (OR: 8.40, [5.10-13.83], p < 0.001) and PaO2/FiO2 < 150 on admission (OR: 2.25, [1.36-3.71], p = 0.002) were independent predictors for CCI.Discussion: One-third of the COVID-19 patients admitted to the ICU were considered as CCI with significantly higher ICU and hospital mortality.","PeriodicalId":48530,"journal":{"name":"Chronic Illness","volume":" ","pages":"86-95"},"PeriodicalIF":1.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996170/pdf/10.1177_17423953231161333.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chronic Illness","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17423953231161333","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: To evaluate the presence of chronic critical illness (CCI) in COVID-19 patients and compare clinical characteristics and prognosis of patients with and without CCI admitted to intensive care unit (ICU).

Methods: It was a retrospective, observational study at a university hospital ICU. Patients were accepted as CCI if they had prolonged ICU stay (≥14 days) and got ≥1 score for cardiovascular sequential organ failure assessment (SOFA) score and ≥2 score in other parameters on day 14 of ICU admission which was described as persistent organ dysfunction.

Results: 131 of 397 (33%) patients met CCI criteria. CCI patients were older (p = 0.003) and frailer (p < 0.001). Their Acute Physiology and Chronic Health Evaluation (APACHE) II and SOFA scores were higher, PaO₂/FiO₂ ratio was lower (p < 0.001). Requirement of invasive mechanical ventilation (IMV), steroid use, and septic shock on admission were higher in the CCI group (p < 0.001). CCI patients had higher ICU and hospital mortality than other patients (54.2% vs. 19.9% and 55.7% vs. 22.6%, p < 0.001, respectively). Regression analysis revealed that IMV (OR: 8.40, [5.10-13.83], p < 0.001) and PaO₂/FiO2 < 150 on admission (OR: 2.25, [1.36-3.71], p = 0.002) were independent predictors for CCI.

Discussion: One-third of the COVID-19 patients admitted to the ICU were considered as CCI with significantly higher ICU and hospital mortality.

查看原文本刊更多论文

COVID-19 重症患者的慢性危重症。

目的评估 COVID-19 患者中是否存在慢性危重症（CCI），并比较重症监护病房（ICU）收治的有 CCI 和无 CCI 患者的临床特征和预后：这是一项在大学医院重症监护室进行的回顾性观察研究。如果患者在重症监护室的住院时间较长（≥14 天），且在入院第 14 天心血管器官功能衰竭顺序评估（SOFA）评分≥1 分，其他指标评分≥2 分，即为持续性器官功能障碍，则被认定为 CCI 患者：397例患者中有131例（33%）符合CCI标准。CCI患者年龄较大（p = 0.003）、体质较弱（p 2/FiO2 比率较低（p p p 2/FiO2 p = 0.002）是CCI的独立预测因素：讨论：在入住重症监护室的 COVID-19 患者中，有三分之一被视为 CCI 患者，其重症监护室和住院死亡率明显较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Chronic Illness Multiple-

CiteScore

3.80

自引率

0.00%

发文量

期刊介绍： Chronic illnesses are prolonged, do not resolve spontaneously, and are rarely completely cured. The most common are cardiovascular diseases (hypertension, coronary artery disease, stroke and heart failure), the arthritides, asthma and chronic obstructive pulmonary disease, diabetes and epilepsy. There is increasing evidence that mental illnesses such as depression are best understood as chronic health problems. HIV/AIDS has become a chronic condition in those countries where effective medication is available.