What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience
Introduction. COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Hindawi-Wiley
2023-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/8545431 |
| _version_ | 1797838049116160000 |
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| author | Hale Bülbül Gözde Derviş Hakim Cengiz Ceylan Murat Aysin Şükran Köse |
| author_facet | Hale Bülbül Gözde Derviş Hakim Cengiz Ceylan Murat Aysin Şükran Köse |
| author_sort | Hale Bülbül |
| collection | DOAJ |
| description | Introduction. COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods. Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan–Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results. A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383–8.625; p=0.008), procalcitonin levels (HR 3.083; 95% CI 1.158–8.206; p=0.024), and lower oxygen saturation (HR 4.121; 95% CI 2.018–8.414; p<0.001) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216–6.487; p=0.016), lower platelet count (HR 2.269; 95% CI 1.012–5.085; p=0.047), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201–4.651; p=0.013) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions. IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes. |
| first_indexed | 2024-04-09T15:34:34Z |
| format | Article |
| id | doaj.art-833c72dc46ca4224925077a4e46c1a3a |
| institution | Directory Open Access Journal |
| issn | 1742-1241 |
| language | English |
| last_indexed | 2024-04-09T15:34:34Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj.art-833c72dc46ca4224925077a4e46c1a3a2023-04-28T00:00:06ZengHindawi-WileyInternational Journal of Clinical Practice1742-12412023-01-01202310.1155/2023/8545431What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center ExperienceHale Bülbül0Gözde Derviş Hakim1Cengiz Ceylan2Murat Aysin3Şükran Köse4Hematology Department, Health Sciences University İzmir Medicine FacultyGastroenterology Department, Health Sciences University İzmir Medicine FacultyHematology Department, Health Sciences University İzmir Medicine FacultyPublic Health DepartmentInfectious Diseases DepartmentIntroduction. COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods. Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan–Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results. A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383–8.625; p=0.008), procalcitonin levels (HR 3.083; 95% CI 1.158–8.206; p=0.024), and lower oxygen saturation (HR 4.121; 95% CI 2.018–8.414; p<0.001) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216–6.487; p=0.016), lower platelet count (HR 2.269; 95% CI 1.012–5.085; p=0.047), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201–4.651; p=0.013) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions. IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes.http://dx.doi.org/10.1155/2023/8545431 |
| spellingShingle | Hale Bülbül Gözde Derviş Hakim Cengiz Ceylan Murat Aysin Şükran Köse What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience International Journal of Clinical Practice |
| title | What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience |
| title_full | What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience |
| title_fullStr | What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience |
| title_full_unstemmed | What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience |
| title_short | What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience |
| title_sort | what is the place of intermediate care unit in patients with covid 19 a single center experience |
| url | http://dx.doi.org/10.1155/2023/8545431 |
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