Aim: The mortality and morbidity of COVID-19 disease are higher in patients with comorbidities. In this study, we staged patients with chronic renal failure hospitalized in the intensive care unit (ICU) and aimed to evaluate the process of the disease according to the stage of failure. Material and Method: The medical records of 249 patients followed in Ankara City Hospital MH3 ICU were reviewed retrospectively. The patients were divided into three stages according to their estimated glomerular filtration rate (e-GFR) value (stage 1: e-GFR≥90 ml/min/1.73 m², stage-2: e-GFR: 15-89 ml/min/1.73 m², stage- 3: e-GFR≤15 ml/min/1.73 m²). Data such as age, gender, comorbidity status, length of stay in the ICU, duration of mechanical ventilation, and mortality rate of the patients were recorded. Patients who were evaluated as stage-2 were also classified into 3 stages (stage-2a: e-GFR: 60-89 ml/min/1.73 m², stage-2b: e-GFR:30-59 ml/min/1.73 m², stage-2c: e-GFR: 15-29 ml/min/1.73 m²) and evaluated with the same parameters. Results: The mean age of all patients was 71 years. It was found that the intubation rate was higher (p=0.012) and the mortality rate was higher (p=0.003) in patients evaluated as stage-3. APACHE II and SOFA scores were higher than the other groups (p=
Objectives:There are recommendations and studies for the corticosteroid treatment of cytokine storm and ARDS in COVID-19 disease. The aim is to evaluate the rates of secondary infections and mortality in COVID-19 patients receiving various doses of corticosteroid treatment in the ICU. Methods: In a retrospective approach, 621 patients were analyzed and recorded in terms of age, gender, duration of mechanical ventilation, length of stay in intensive care, CRP, procalcitonin, LDH, IL-6, lymphocyte, D-dimer, ferritin values and corticosteroid doses as well as blood, urine, and tracheal aspiration growths. The patients were examined in 6 groups those who never took corticosteroids and those who took Methylprednisolone (MP) in doses of 250 mg, >250 mg, 80 mg, 40 mg, and 6 mg dexamethasone. The data were evaluated to determine if there have been significant relationships between corticosteroid doses and the rates of secondary infection and mortality. Results: The mean hospital stay of the patients was 11.2 ± 7.71 days, and the mean of invasive mechanical ventilation was 7.5 days. There was no significant difference between patients who did not use corticosteroids and patients who received 40 mg MP for the length of hospital stay. The length of hospital stay was significantly longer in the corticosteroid groups (p
Background: It is known that COVID-19 has a worse and poorer progression, which often might lead to death in those with comorbidities. Multiple studies have recently examined the clinical course of cancer patients with COVID-19 and new guidelines have been developed to manage this group of patients. This study aimed to evaluate the clinical course and mortality rate of cancer patients admitted to the intensive care unit (ICU) for COVID-19. Material and Method: The demographic characteristics, detailed medical history and laboratory findings of 140 patients with malignancy, who were treated in the COVID-19 Intensive Care Unit of Ankara City Hospital, were evaluated retrospectively. Gender, age, comorbidity, length of stay in the ICU, mortality rates, length of stay on a mechanical ventilator, cytokine storm scores, ferritin, interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH), lymphocyte count and treatment options were compared. The patients were divided into two groups: solid and hematological malignancies. Results: One hundred eight of 140 patients were diagnosed with solid organ malignancy and 32 with hematological malignancy. The most common comorbidity was found to be hypertension. A total of 94 patients died during their ICU stay. While the most common solid organ malignancies were malignancies of the lower gastrointestinal tract and lung cancers, multiple myeloma (MM) was the most common hematological malignancy. There was no significant difference between the two groups in terms of cytokine storm scores , duration of hospitalization and mechanical ventilation. Levels of Ferritin and LDH were found to be significantly higher in patients with hematological malignancies, while D-dimer was significantly higher in solid organ malignancies. A high level of CRP and IL-6 was associated with COVID-19 mortality. Lymphopenia was associated with increased mortality in patients with solid organ malignancy. However, there was no difference in mortality rate among both groups. Although the mortality was significantly higher in the patient group receiving chemotherapy, there were no significant differences in mortality for the duration of receiving chemotherapy. Conclusion: The results of this study suggested that cancer was associated with severe clinical outcomes and a 67% mortality rate among patients with COVID-19. However, despite the changes in patients’ demographic, clinical and laboratory characteristics, no difference in mortality rate was detected in patients with hematological and solid organ malignancies due to COVID-19 infection.
Amaç: Akut böbrek yetmezliği (ABY) yoğun bakım hastalarında mortaliteyi etkileyen en önemli faktörlerden biridir. Bu çalışmanın amacı, ürik asit düzeyleri ile akut böbrek hasarı (AKI) / ABY arasında bir ilişki olup olmadığını aydınlatmaktır. Gereç ve Yöntem: Bu retrospektif çalışmamıza, önceden böbrek hastalığı olmayan ve glomerüler filtrasyon hızı (GFR) 80-120 ml/dakika olan hastanemiz yoğun bakım ünitesine kabul edilen toplam 1000 hasta dahil edildi. Yoğun bakım ünitesinde AKI gelişimi RIFLE kriterleri ile değerlendirildi. AKI gelişen hastalarda renal replasman tedavisi endikasyonu olup olmadığına bakıldı. Bilinci kapalı kişiler ve COVID-19 hastaları dahil yoğun bakım ünitesindeki tüm hastalar analize dahil edilmiştir. Bulgular: Bireylerin %27,1’inde (n=271) AKI görüldü. AKI’lı hastaların %44.3’üne (n=120) hemodiyaliz uygulanmıştı. Hemodiyaliz nedenleri olguların %36’sında iskemi, %32’sinde sepsis ve multifaktöriyel nedenler idi. Potasyum dışındaki tüm parametrelerde (üre, kreatinin, ürik asit ve sodyumda) başlangıca göre artmıştı (p
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