Search

Objective: The patients admitted to coronavirus disease-2019 (COVID-19) intensive care units (ICUs) with the suspicion of COVID-19 in the first four months of the pandemic were evaluated both in diagnostics and according to periods of the pandemic. Materials and Methods: The data of 1,430 patients admitted to the COVID-19 ICUs were recorded with the same algorithm in a single-center retrospectively. Patients were classified as COVID-19 and non-COVID-19 patients according to polymerase chain reaction results, radiological and clinical findings. Also, COVID-19 patients were compared as dying and surviving. Additionally, the data of patients admitted to COVID-19 ICUs during the onset of the pandemic and during the normalization period were also compared. Results: Of 1,430 patients, 630 were included in the COVID-19 group and 800 in the non-COVID-19 group. While there was a significant difference in the mean age of the groups, there was no difference between the genders (p=0.001, p=0.262 respectively). The age in the COVID-19 and deceased group was higher than that in the survivors (p<0.001). The most common presenting symptom was dyspnea (51.2%), while hypertension’s most common comorbidity (51.2%). During the normalization period, the rate of patients admitted to the ICU with the diagnosis of COVID-19 and the mortality rates in the ICU was higher. Conclusion: The initial period of the pandemic was spent understanding COVID-19, which entered our lives as a mystery at the same time. It was a guiding period for us to treat patients more effectively while protecting the community and healthcare professionals. [ABSTRACT FROM AUTHOR]

Objective: The number of patients with COVID-19 has rapidly increased, thereby exceeding the capacities of health systems and causing serious losses in affected countries because of the rapid spreading potential, high virulence, and lack of vaccine and proven antiviral therapy. This may indicate the importance of protocol-based treatments in maintaining the treatment process accurately, with minimal errors. This study aimed to present the results of a protocol-based treatment prepared in accordance with the “Surviving Sepsis Campaign COVID-19 treatment guideline.” Materials And Methods: This retrospective and prospective study used data of five hospitals. Intensive care and treatment approaches were carried out in accordance with the “COVID-19 approach protocol” prepared according to the “Surviving Sepsis Campaign COVID-19 treatment guideline.” Results: A total of 1143 patients admitted to five hospitals were hospitalized with a prediagnosis of COVID-19, and 115 patients needed intensive care. Among them, patients without COVID-19 were excluded and the remaining 77 patients were evaluated. In this study, 9 (11.7%) of the 77 patients were lost. While the mortality rate did not differ by sex (p=0.661), the mean age of deceased patients was significantly higher (p=0.006). Considering their comorbidities, the mortality rates of patients with hypertension, chronic renal failure, and cancer were significantly higher (p=0.034, p=0.014, and p=0.007, respectively). Conclusion: The mortality rate in this series may suggest that the treatments performed in line with the “Survival in Sepsis Campaign COVID-19 treatment guideline” are useful. However, when the causes of mortality and morbidity were evaluated, good observation of neurological, infective, respiratory, and immune complications may be considered the main factor in reducing mortality and should be included in the guideline. [ABSTRACT FROM AUTHOR]

Introduction: As in the whole world, the elderly population is increasing in Turkey and more geriatric patients are hospitalized in intensive care units (ICUs). ICUs are places where expensive treatments are made and resources must be used well. There are not enough studies in Turkey on the ICU hospitalization rates and treatment outcomes of elderly patients, whose comorbidities added and life expectancy rate decreases with age. In this study, we aimed to investigate the demographic and clinical characteristics of elderly patients admitted to the ICU. Materials and Methods: The medical records of the elderly patients (≥65 years old) in the ICU (July -December 2022) were retrospectively reviewed. Medical records were analyzed for age, gender, comorbidities, APACHE II scores, and outcomes.The patients were compared by dividing them into 2 groups as survived and nonsurvived. Results: A total of 843 patients were admitted to ICU during the study period, 40% (n=339) of the patients were ≥65 years old, 7.2% (n=61) were ≥85 years old. A total of 188 patients (55.5%) required invasive mechanical ventilation (IMV), 172 patients (50.7%) received at least one vasoactive drug, and 36 patients (10.6%) required hemodialysis. The mortality rate was 41.6%. The requirament for inotropic support, hemodialysis, and IMV were significantly higher in the nonsurvived group (p=0.000 for all). The mean ICU length of stay was 14.5 days (range 1-129). Data for survived and non-survived groups are summarized in Table 1. Conclusion: High APACHE-II score, the requirement for inotropic support, hemodialysis, and IMV were found to be significantly higher in the nonsurvived group. When the response to maximal treatment isnot sufficient and survival chances with satisfactory conditions are almost non-existent, should the decision of therapeutic limitation be applied frequently? In order to answer this question, we think that more studies are needed about these topics in Turkey. These patients, who poor response to advanced treatment options, seem to have a substantial effect on ICU capacity [ABSTRACT FROM AUTHOR]