Evaluation of diaphragm thickness to predict intubation requirement and mortality in critical COVID-19 patients

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CANKAR DAL H., Dolek B. A., Beyoğlu M. A., Acar D., GÖZÜKARA M. G., TURAN S.

Saudi Medical Journal, cilt.43, sa.10, ss.1120-1127, 2022 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 10
  • Basım Tarihi: 2022
  • Doi Numarası: 10.15537/smj.2022.43.10.20220469
  • Dergi Adı: Saudi Medical Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Arab World Research Source, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1120-1127
  • Anahtar Kelimeler: COVID-19, diaphragm, computed tomography, mortality, mechanical ventilation
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objectives: To investigate the value of measuring the diaphragm thickness)DT(on thorax computed tomography)CT(at intensive care unit)ICU(admission for predicting intubation requirement and mortality among COVID-19 patients. Methods: This study was carried out in Ankara City Hospital, Ankara, Turkey, from September 2020 to January 2021, with 94 critical COVID-19 patients. The patients’ demographic characteristics, laboratory parameters, DT measurements, mechanical ventilation)MV(requirements, and mortality statuses were retrospectively screened. The relationships between DT on initial CT, MV requirement, and mortality were investigated. Results: Diaphragm thickness was lower in patients who required intubation after ICU admission than in non-intubated patients)p=0.006(; it was also lower in non-survivors)p=0.009(. The threshold values for MV need was 3.35 mm)p=0.004(and 3.275 mm for mortality)p=0.006(, according to the receiver operating characteristic analysis used to assess the predictive potential of DT. The non-survivor group had a greater neutrophil-to-lymphocyte ratio)p=0.026(. Absolute neutrophil count)p=0.017(, neutrophil-to-lymphocyte ratio)p=0.010(, and interleukin-6 levels)p=0.027(were higher among patients requiring MV than among non-intubated patients. Conclusion: Mortality and MV requirements can be predicted from DT measurements. Diaphragm thickness can facilitate the identification of high-risk patients on CT evaluation at ICU admission.