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Clinical Outcomes And Predictors Of Mortality In COVID-19 Patients Admitted To A High Dependency Unit In Pakistan-A
Samar Fatima1, Sara Shamim1, Taymmia Ejaz1
1Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Insights
In-hospital mortality for coronavirus disease 2019 (COVID-19) patients in high dependency units was 11%. Older age and multimorbidity were key predictors of mortality in these critically ill COVID-19 patients.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant global health threat, necessitating research into patient outcomes in critical care settings.
- High dependency units (HDUs) manage patients with severe COVID-19 requiring close monitoring and intervention.
Purpose of the Study:
- To investigate the outcomes of patients admitted to the high dependency unit with COVID-19.
- To identify predictors of in-hospital mortality among these patients.
Main Methods:
- A retrospective study was conducted at a tertiary care hospital in Karachi, Pakistan.
- Data from adult COVID-19 patients admitted to the HDU between March 1 and June 30, 2020, were analyzed.
- Outcomes were categorized as recovered, deteriorated but survived, or expired. Statistical analysis was performed using SPSS 22.
Main Results:
- Out of 245 admitted patients, 207 formed the study sample after excluding those with missing data.
- The overall in-hospital mortality rate was 11% (23 out of 207 patients).
- Significant predictors of disease progression and mortality included older age, multimorbidity, and elevated D-Dimer levels (p<0.05).
Conclusions:
- Mortality in the HDU setting for COVID-19 patients was substantial.
- Older patients and those with multiple comorbidities faced a higher risk of mortality.
- Early identification of these risk factors is crucial for improving patient management and outcomes in severe COVID-19 cases.
Objectives:
To determine the outcomes and predictors of in-hospital mortality of patients admitted to high dependency unit with coronavirus disease 2019 infection.
Methods:
The retrospective study was conducted at a tertiary care hospital in Karachi, and comprised data of adult coronavirus disease 2019 patients of either gender admitted to the high dependency unit from March 1 to June 30, 2020. Outcomes were categorised as patients 'recovered without deterioration', 'deteriorated but survived', and 'deteriorated but expired'. Data was analysed using SPSS 22.
Results:
Of the 525 patients with confirmed infection, 245(46.6%) were admitted to the high dependency unit. Leaving out 38(15.5%) cases with missing data, 207(84.5%) cases formed the study sample; 156(75.4%) males and 51(24.6%) females. The overall mean age was 56.9±14years (range: 24-86 years). The most common comorbid condition was hypertension 105(50.7%), and the most common reason for critical care was hypoxic respiratory failure 199(96.1%). Of the total, 153(74%) patients recovered, 31(15%) deteriorated, and mortality was the outcome in 23(11%). There was no significant effect of drug treatment on mortality (p>0.05). Age, multimorbidity and high D-Dimer level were significantly associated with disease progression and mortality (p<0.05).
Conclusions:
Mortality was high among coronavirus disease 2019 patients who were older and had multimorbidity.
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