Balkan Medical Journal
Original Articles

Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units

1.

Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey

2.

Division of Intensive Care Medicine, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey

3.

Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey

4.

Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey

5.

Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey

6.

Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey

7.

Intensive Care Unit, Ministry of Health, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey

8.

Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey

9.

Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey

10.

Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey

11.

Division of Intensive Care Medicine, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey

12.

Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey

13.

Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey

14.

Division of Intensive Care Medicine, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey

15.

Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey

16.

Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey

17.

Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey

18.

Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey

19.

Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey

20.

Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey

21.

Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey

22.

Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey

23.

Division of Intensive Care Medicine, Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey

24.

Division of Intensive Care Medicine, Department of Chest Diseases, Çukurova University School of Medicine, Adana, Turkey

25.

Division of Intensive Care Medicine, Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey

Balkan Medical Journal 2021; 38: 296-303
DOI: 10.5152/balkanmedj.2021.21188
Read: 440 Downloads: 135 Published: 05 August 2021

Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world.

Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure.

Study design: Retrospective, observational cohort.

Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded.

Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050).

Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.

Cite this article as: Gündoğan K, Akbudak İH, Hancı P, et al. Clinical outcomes and independent risk factors for 90-day mortality in critically ill patients with respiratory failure infected with SARS-COV-2: A multicenter study in Turkish intensive care units. Balkan Med J. 2021;38(5): 296-303.

Files
ISSN 2146-3123 EISSN 2146-3131