{"title":"基于ct的老年COVID-19患者膈膜厚度与ICU入院风险分析","authors":"Mercan Tastemur, Cagla Ozdemir, Esin Olcucuoğlu, Gunes Arik, Ihsan Ates, Kamile Silay","doi":"10.1186/s12890-025-03599-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the impact of diaphragm thickness (DT) on the prognosis of elderly patients infected with COVID-19, particularly with regard to the necessity of intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>Between August 2020 and January 2021, 188 patients aged ≥ 65 years who were admitted to the internal medicine department of our hospital with a diagnosis of COVID-19 infection, were included in this study. The patients' DTs of the patients were measured by a radiologist using computed tomography (CT) scans from the right and left diaphragm dome level. DT was compared with the progression of respiratory distress and the necessity of intensive care. In statistical analysis, p < 0.05 was considered significant.</p><p><strong>Results: </strong>Right DT was higher in the group of patients with admission to the ICU (p = 0.11). According to multivariate logistic regression analysis, ferritin level (OR = 1; 95% CI = 1-1; p = 0.014), IL-6 level (OR = 1.004; 95% CI = 1-1.007; p = 0.045) and higher right DT (OR = 11.015; 95% CI = 3.739-32.447; p = 0.035) were found to be independent risk factors predicting the ICU admission in COVID-19 patients. There was no significant association with left DT. The predictive value of right DT for ICU requirement in COVID-19 patients was evaluated by ROC analysis. The ROC analysis showed a cut-off value > 1.8, AUC = 0.632, p = 0.009, 95% Cl (0.558-0.701). In correlation analysis, a positive correlation was found between right DT and ICU admission (r = 0.331, p < 0.001).</p><p><strong>Conclusion: </strong>Our study is the first to evaluate dome-level DT with CT in elderly patients with COVID-19. In the elderly population, higher right DT levels have been observed to enhance the probability of ICU admission. This may be due to the fact that our sample group consists only of elderly people and the effects of COVID-19. We believe that further validation with more comprehensive studies is needed for DT assessment for clinical treatment decisions, particularly in COVID-19 patients. In addition, we think that the proposal for a standardized measurement site and method for DT measurement will be a guide for future studies.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"152"},"PeriodicalIF":2.6000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969763/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diaphragm thickness and ICU admission risk in elderly COVID-19 patients: a CT-based analysis.\",\"authors\":\"Mercan Tastemur, Cagla Ozdemir, Esin Olcucuoğlu, Gunes Arik, Ihsan Ates, Kamile Silay\",\"doi\":\"10.1186/s12890-025-03599-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The objective of this study was to examine the impact of diaphragm thickness (DT) on the prognosis of elderly patients infected with COVID-19, particularly with regard to the necessity of intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>Between August 2020 and January 2021, 188 patients aged ≥ 65 years who were admitted to the internal medicine department of our hospital with a diagnosis of COVID-19 infection, were included in this study. The patients' DTs of the patients were measured by a radiologist using computed tomography (CT) scans from the right and left diaphragm dome level. DT was compared with the progression of respiratory distress and the necessity of intensive care. In statistical analysis, p < 0.05 was considered significant.</p><p><strong>Results: </strong>Right DT was higher in the group of patients with admission to the ICU (p = 0.11). According to multivariate logistic regression analysis, ferritin level (OR = 1; 95% CI = 1-1; p = 0.014), IL-6 level (OR = 1.004; 95% CI = 1-1.007; p = 0.045) and higher right DT (OR = 11.015; 95% CI = 3.739-32.447; p = 0.035) were found to be independent risk factors predicting the ICU admission in COVID-19 patients. There was no significant association with left DT. The predictive value of right DT for ICU requirement in COVID-19 patients was evaluated by ROC analysis. The ROC analysis showed a cut-off value > 1.8, AUC = 0.632, p = 0.009, 95% Cl (0.558-0.701). In correlation analysis, a positive correlation was found between right DT and ICU admission (r = 0.331, p < 0.001).</p><p><strong>Conclusion: </strong>Our study is the first to evaluate dome-level DT with CT in elderly patients with COVID-19. In the elderly population, higher right DT levels have been observed to enhance the probability of ICU admission. This may be due to the fact that our sample group consists only of elderly people and the effects of COVID-19. We believe that further validation with more comprehensive studies is needed for DT assessment for clinical treatment decisions, particularly in COVID-19 patients. 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引用次数: 0
摘要
背景：本研究旨在探讨膈膜厚度（DT）对老年COVID-19感染患者预后的影响，特别是对入住重症监护病房（ICU）的必要性的影响。方法：选取2020年8月至2021年1月在我院内科确诊为COVID-19感染的188例年龄≥65岁的患者作为研究对象。由放射科医生使用计算机断层扫描（CT）从左右膈球水平测量患者的dt。比较DT与呼吸窘迫的进展及重症监护的必要性。结果：入院ICU组右DT较高（p = 0.11）。经多元logistic回归分析，铁蛋白水平(OR = 1；95% ci = 1-1；p = 0.014)， IL-6水平(OR = 1.004；95% ci = 1-1.007；p = 0.045)和更高的右DT (OR = 11.015；95% ci = 3.739-32.447；p = 0.035)是预测新冠肺炎患者入住ICU的独立危险因素。与左DT无显著相关。采用ROC分析评价右DT对COVID-19患者ICU需求的预测价值。ROC分析显示截断值bbb1.8, AUC = 0.632, p = 0.009, 95% Cl（0.558-0.701）。在相关分析中，右侧DT与ICU入院率呈正相关（r = 0.331, p）。结论：本研究首次对老年COVID-19患者的CT穹窿水平DT进行评价。在老年人群中，观察到较高的右DT水平可增加ICU入院的概率。这可能是由于我们的样本组仅由老年人和COVID-19的影响组成。我们认为，需要通过更全面的研究进一步验证DT评估临床治疗决策，特别是在COVID-19患者中。此外，我们认为提出标准化的DT测量地点和方法将对今后的研究起到指导作用。临床试验：不适用。
Diaphragm thickness and ICU admission risk in elderly COVID-19 patients: a CT-based analysis.
Background: The objective of this study was to examine the impact of diaphragm thickness (DT) on the prognosis of elderly patients infected with COVID-19, particularly with regard to the necessity of intensive care unit (ICU) admission.
Methods: Between August 2020 and January 2021, 188 patients aged ≥ 65 years who were admitted to the internal medicine department of our hospital with a diagnosis of COVID-19 infection, were included in this study. The patients' DTs of the patients were measured by a radiologist using computed tomography (CT) scans from the right and left diaphragm dome level. DT was compared with the progression of respiratory distress and the necessity of intensive care. In statistical analysis, p < 0.05 was considered significant.
Results: Right DT was higher in the group of patients with admission to the ICU (p = 0.11). According to multivariate logistic regression analysis, ferritin level (OR = 1; 95% CI = 1-1; p = 0.014), IL-6 level (OR = 1.004; 95% CI = 1-1.007; p = 0.045) and higher right DT (OR = 11.015; 95% CI = 3.739-32.447; p = 0.035) were found to be independent risk factors predicting the ICU admission in COVID-19 patients. There was no significant association with left DT. The predictive value of right DT for ICU requirement in COVID-19 patients was evaluated by ROC analysis. The ROC analysis showed a cut-off value > 1.8, AUC = 0.632, p = 0.009, 95% Cl (0.558-0.701). In correlation analysis, a positive correlation was found between right DT and ICU admission (r = 0.331, p < 0.001).
Conclusion: Our study is the first to evaluate dome-level DT with CT in elderly patients with COVID-19. In the elderly population, higher right DT levels have been observed to enhance the probability of ICU admission. This may be due to the fact that our sample group consists only of elderly people and the effects of COVID-19. We believe that further validation with more comprehensive studies is needed for DT assessment for clinical treatment decisions, particularly in COVID-19 patients. In addition, we think that the proposal for a standardized measurement site and method for DT measurement will be a guide for future studies.
期刊介绍：
BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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