Prognostic Factors and Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted to the Intensive Care Unit: An Aid for Triage, Counseling, and Resource Allocation.
covid-19
critical care
icu
prognostic scores
sars-cov- 2
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
accepted:
22
07
2021
entrez:
29
7
2021
pubmed:
30
7
2021
medline:
30
7
2021
Statut:
epublish
Résumé
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings. To identify determinants of in-hospital mortality and examine the accuracy of seven early warning scores in predicting in-hospital mortality. This is a retrospective study conducted in Kuwait from July 2020 to March 2021, and participants were adult patients with a positive test on the real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and who met the criteria for ICU admission. Data collected included: demographics, clinical status on hospital arrival, laboratory test results, and ICU course. Furthermore, we calculated seven early warning scores for each of our patients. A total of 133 patients were admitted to our COVID-19 ICU with a median age of 59 years. Arrival to ICU on mechanical ventilation (MV), developing in-hospital complications, having chronic kidney disease (CKD), having a high white blood count (WBC), lactate dehydrogenase (LDH), lactate, or urea levels were found to be significant predictors of in-hospital mortality. Furthermore, the 4C mortality score for COVID-19, VACO index for COVID-19 mortality, and the PRIEST COVID-19 clinical severity score proved to be the most superior in predicting in-hospital mortality. Identifying high-risk patients and those with a poor prognosis allows for efficient triaging and the delivery of high-standard care while minimizing the strain on the healthcare system.
Sections du résumé
BACKGROUND
BACKGROUND
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings.
AIM
OBJECTIVE
To identify determinants of in-hospital mortality and examine the accuracy of seven early warning scores in predicting in-hospital mortality.
METHODS
METHODS
This is a retrospective study conducted in Kuwait from July 2020 to March 2021, and participants were adult patients with a positive test on the real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and who met the criteria for ICU admission. Data collected included: demographics, clinical status on hospital arrival, laboratory test results, and ICU course. Furthermore, we calculated seven early warning scores for each of our patients.
RESULTS
RESULTS
A total of 133 patients were admitted to our COVID-19 ICU with a median age of 59 years. Arrival to ICU on mechanical ventilation (MV), developing in-hospital complications, having chronic kidney disease (CKD), having a high white blood count (WBC), lactate dehydrogenase (LDH), lactate, or urea levels were found to be significant predictors of in-hospital mortality. Furthermore, the 4C mortality score for COVID-19, VACO index for COVID-19 mortality, and the PRIEST COVID-19 clinical severity score proved to be the most superior in predicting in-hospital mortality.
CONCLUSION
CONCLUSIONS
Identifying high-risk patients and those with a poor prognosis allows for efficient triaging and the delivery of high-standard care while minimizing the strain on the healthcare system.
Identifiants
pubmed: 34322358
doi: 10.7759/cureus.16577
pmc: PMC8299433
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e16577Informations de copyright
Copyright © 2021, Burhamah et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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