COVID-19 dýþý yoðun bakým ünitelerinde pandemi ve pandemi öncesi dönem arasýndaki demografik ve klinik özelliklerin karþýlaþtýrýlmasý: Retrospektif bir çalýþma

AMAÇ: Koronavirüs pandemisinin önemli bir sorunu, yoðun bakým ünitesi (YBÜ) desteðine ihtiyaç duyan hastalarýn son derece sýnýrlý bir süre içinde artmasýdýr. Sonuç olarak, çoðu ülke yoðun bakým ünitelerinde (YBÜ) COVID-19 bakýmýna öncelik vermiþ ve acil servis ve yoðun bakým ünitelerinde hastane kapasitesini artýrmak için yeni düzenlemeler yapmýþtýr. Bu çalýþmada, COVID-19 pandemisi döneminde (pandemi öncesi dönem) COVID-19 dýþý yoðun bakýmlarda yatan hasta sayýsý, klinik ve demografik özelliklerindeki deðiþikliklerin bir önceki yýla göre deðerlendirilmesi ve pandeminin etkilerinin ortaya konulmasý amaçlanmýþtýr.
GEREÇ VE YÖNTEM: 11 Mart 2019-11 Mart 2021 tarihleri arasýnda hastanemizin COVID-19 dýþý yoðun bakým ünitelerinde yatan hastalar çalýþmaya dahil edildi. Hastalar COVID döneminin baþlama tarihine göre iki gruba ayrýldý. Hasta verileri geriye dönük olarak hastane bilgi sistemi ve YBÜ deðerlendirme formlarýndan taranarak kaydedildi. Demografik bilgiler (yaþ ve cinsiyet), komorbiditeler, COVID 19 PCR sonucu, yoðun bakým yatýþ yeri, yoðun bakýma yatan hastalarýn tanýlarý, yoðun bakýmda kalýþ süreleri, Glasgow koma skalasý ve ölüm oranlarý ile APACHE II skoru toplandý. BULGULAR: Pandemi öncesi dönemde (Grup 1) 1011 hasta (413 kadýn, 598 erkek) ve pandemi döneminde (Grup 2) 1281 hasta (572 kadýn, 709 erkek) olmak üzere toplam 2292 hasta analiz edildi. YBÜ’ye baþvuran hastalarýn tanýlarý gruplar arasýnda karþýlaþtýrýldýðýnda, postoperatif, spontan dolaþýmýn geri dönüþü (ROSC), zehirlenme, multitravma ve diðer nedenler arasýnda istatistiksel olarak anlamlý fark vardý. Pandemi döneminde hastalarýn yoðun bakýmda kalýþ süresi istatistiksel olarak anlamlý þekilde daha uzundu.
TARTIÞMA: COVID-19 dýþý yoðun bakýmlarda yatan hastalarýn klinik ve demografik özelliklerinde deðiþiklikler gözlendi. Pandemi döneminde hastalarýn yoðun bakýmda kalýþ sürelerinin arttýðýný gözlemledik. Bu durum nedeniyle pandemi döneminde yoðun bakým ve diðer yataklý servislerin daha etkin yönetilmesi gerektiðini düþünüyoruz.

Comparison of demographic and clinical characteristics between pandemic and pre-pandemic period in non-COVID intensive care units: a retrospective study

BACKGROUND: A major problem of the coronavirus pandemic is the increase of patients requiring intensive care unit (ICU) sup-port in an extremely limited period of time. As a result, most countries have prioritized coronavirus disease 2019 (COVID-19) care in ICUs and take new arrangements to increase hospital capacity in emergency department and ICUs. This study aimed to evaluate the changes in the number, clinical and demographic characteristics of patients hospitalized in non-COVID ICUs during the COVID-19 pandemic period compared to the previous year (pre-pandemic period), and to reveal the effects of the pandemic.
METHODS: Hospitalized patients in non-COVID ICUs of our hospital between 11 March 2019 and 11 March 2021 were included in the study. The patients were divided into two groups according to date of the start of the COVID period. Patient data were scanned and recorded retrospectively from hospital information system and ICU assessment forms. Information regarding demographics (age and gender), comorbidities, COVID 19 polymerase chain reaction result, place of ICU admission, the diagnoses of patients admitted to ICU, length of ICU stay, Glasgow coma scale and mortality rates, and the Acute Physiology and Chronic Health Evaluation II score were collected.
RESULTS: A total of 2292 patients were analyzed, including 1011 patients (413 women and 598 men) in the pre-pandemic period (Group 1) and 1281 patients (572 women and 709 men) in the pandemic period (Group 2). When the diagnoses of patients admitted to ICU were compared between the groups, there was a statistically significant difference between post-operation, return of spon-taneous circulation, intoxication, multitrauma, and other reasons. In the pandemic period, the patients had a statistically significant longer length of ICU stay.
CONCLUSION: Changes were observed in the clinical and demographic characteristics of patients hospitalized in non-COVID-19 ICUs. We observed that the length of ICU stay of the patients increased during the pandemic period. Due to this situation, we think that intensive care and other inpatient services should be managed more effectively during the pandemic.