Effect of APACHE-II and the Age-Adjusted CHARLSON Comorbidity Index at Predicting Mortality in Patients with COVID-19

Authors : Şermin EMİNOGLU, Seyda Efsun OZGUNAY

Pages : 430-437

Doi:10.19127/bshealthscience.1109017

View : 24 | Download : 8

Publication Date : 2022-09-01

Article Type : Research Paper

Abstract :The COVID-19 pandemic disproportionately affects patients with comorbidities. Comprehensive comorbidity assessment is important in establishing the risk stratification of patients with COVID-19 after hospital admission. In this study, our aim is to investigate the effectiveness of Acute Physiology and Chronic Health Assessment II insert ignore into journalissuearticles values(APACHE-II); and Age Adjusted Charlson Comorbidity Index insert ignore into journalissuearticles values(ACCI); in predicting mortality in COVID-19 patients admitted to the Intensive Care Unit insert ignore into journalissuearticles values(ICU);. Patients aged >18 years who were admitted to the intensive care unit with the diagnosis of COVID-19 pneumonia in the Health Sciences University Bursa Yüksek İhtisas Training and Training Hospital between July 2021 and September 2021 were included in the study. The medical records of the patients were then scanned into the hospital automation system. Demographics, comorbidities, clinical features, laboratory parameters, APACHE-II score, treatments, and outcomes were recorded in a standard form. ACCI score was calculated from the data and recorded. The 276 patients analyzed were divided into two groups as surviving insert ignore into journalissuearticles values(n=129); and developing mortality insert ignore into journalissuearticles values(n=147);. The mortality rate was 58.93%, mostly male insert ignore into journalissuearticles values(58%);, median age 65 years, ACCI score 1 insert ignore into journalissuearticles values(IQR.3); and APACHE-II score 2 insert ignore into journalissuearticles values(IQR.8);. There was no difference between the groups in terms of age, gender distribution and APACHI-II score insert ignore into journalissuearticles values(P= 0.519, P= 0.927, P= 0.364, respectively);. The groups did not differ in terms of comorbidity except for chronic renal failure insert ignore into journalissuearticles values(CRF);, and CRF was significantly higher in patients who developed mortality insert ignore into journalissuearticles values(P= 0.037);. The ACCI score was found to be higher in patients who developed mortality insert ignore into journalissuearticles values(P= 0.034);. Death risk; Those with an ACCI score of >2 were 2.26 times higher than those with an ACCI score of ≤2 insert ignore into journalissuearticles values(P= 0.021);. The APACHI-II score did not differ between the groups in terms of mortality insert ignore into journalissuearticles values(P= 0.380);. As a result, high ACCI score was found to be effective in predicting mortality. It could potentially be used to identify at-risk patients infected with COVID-19 and to predict their clinical status.
Keywords : COVID 19 pneumonia, Comorbidity, Index, APACHI II score, Intensive care unit, Mortality