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Evaluation of Patients Diagnosed with COVID-19 and Followed up in Intensive Care Unit Requiring Continuous Renal Replacement Therapy Using APACHE-II and SOFA Scores

Year 2023, Volume: 18 Issue: 3, 69 - 77, 20.11.2023

İrem Akın Şen Şenol Arslan Cem Şen

https://doi.org/10.17517/ksutfd.1164300

Abstract

Objective: In 5% of COVID-19 cases, the requirement for intensive care unit (ICU) hospitalization develops through the disease course. This study aimed to evaluate the mortality rates of the critically ill COVID-19 patients followed up in the ICU who needed continuous renal replacement (CRRT) treatment using APACHE-II and SOFA scores.
Materials and Methods: With the APACHE 2 and SOFA Scoring System, 13 patients hospitalized in the Anesthesia Intensive Care Unit of the Education Research Hospital between March and September 2020 and required CRRT were evaluated. APACHE-II and SOFA scores were recorded before and two days after the CRRT application. Scoring systems were compared in terms of mortality.
Results: Considering the APACHE-II and SOFA scoring systems before and after CRRT, it was determined that the APACHE-II scoring system before CRRT was more determinant in predicting the estimated mortality rate. However, after CRRT, it was observed that APACHE-II and SOFA scoring systems were not different from each other. When the duration of hospitalization was evaluated, a negative correlation was found between APACHE-II and SOFA scoring systems.
Conclusion: Our study concluded that mortality was higher in men and patients with hypertension, consistent with the literature. Our study revealed no difference in mortality between APACHE-II and SOFA scores after CRRT and that both systems could be used. Although it is thought that these results may contribute to future follow-up and treatment methods, new studies are needed.

Keywords

CRRT APACHE-II SOFA Score COVID-19

References

  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
  • Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50:489-94.
  • Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA. 2020;323:1239-42.
  • Shang Y, Pan C, Yang X, Zhong M, Shang X. Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China. Ann Intensive Care. 2020;10:73. https:// doi.org/10.1186/s13613-020-00689-1
  • Varatharaj A, Thomas N, Ellul MA, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020;7:875-82.
  • Berlin DA, Gulick RM, Martinez FJ. Severe COVID-19. N Engl J Med. 2020;383:2451-60. https://doi. org/10.1056/NEJMcp2009575
  • Wang D,Hu B,Hu C et. al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-9.
  • Haertel F, Reisberg D, Peters M, et al. Prognostic value of tissue oxygen saturation using a vascular occlusion test in patients in the early phase of multiorgan dysfunction syndrome. Shock. 2019;51(6):706–12.
  • Hoste EA, Clermont G, Kersten A, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care. 2006;10:R73-R73.
  • Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C, An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med. 2006;34:1913-7.
  • Uchino S, Kellum JA, Bellomo R, et al.Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813-8.
  • Schwartz RD, Messana JM, Orzol, FK Port. Comparing continuous hemofiltration with hemodialysis in patients with severe acute renal failure. Am J Kidney Dis. 1999; 34: 424–32.
  • Kresse S, Schlee H, Deuber HJ, Koall W. Osten B. Influence of renal replacement therapy on outcome of patients with acute renal failure. Kidney Int Suppl. 1999; 56: 75–8.
  • Guerin C, Girard R, Selli JM, Louis A.Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care unit; results from a multicentre prospective epidemiological survey. Intensive Care Med. 2002; 28:1411–8.
  • Chang JW, Yang WS, Seo JW, Lee JS, Lee SK, Park SK. Continuous venovenous hemodiafiltration versus hemodialysis as renal replacement therapy in patients with acute renal failure in the intensive care unit. Scand J Urol Nephrol. 2004; 38(5): 417–21.
  • Cho KC, Himmelfarb J, Paganini E, et al. Survival by dialysis modality in critically ill patients with acute kidney injury. J Am Soc Nephrol. 2006; 17(11): 3132–8.
  • Mica L, Furrer E, Keel M, Trentz O. Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients. Eur J Trauma Emerg Surg. 2012;38(6):665–71.
  • Huang W, Qin S, Sun Y, et al. Establishment of multiple organ dysfunction syndrome early warning score in patients with severe trauma and its clinical significance: a multicenter study. Zhonghua Wei Zhong Bing Jiu Xue. 2018;30(1):41–6.
  • Bahtouee M, Eghbali SS, Maleki N, et al. Acute physiology and chronic health evaluation II score for the assessment of mortality prediction in the intensive care unit: a single-centre study from Iran. Nurs Crit Care. 2019;24(6):375–80
  • Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801–10.
  • Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8:506-17.
  • Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475- 81.
  • Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically Ill patients in the seattle regioncase series. N Engl J Med. 2020;382:2012-22.
  • Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the lombardy region, Italy. JAMA. 2020;323:1574-81.
  • Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180:934-43.
  • Ko H, Yan M, Gupta R, et al.Predictors of survival in patients with advanced gastrointestinal malignancies admitted to the intensive care unit. Oncologist. 2019;24(4):483–90.
  • Tee YS, Fang HY, Kuo IM, Lin YS, Huang SF, Yu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018;97(7):e9654.
  • Khwannimit B, Bhurayanontachia R, Vattanavanit V. Comparision of the accuracy of three early warning scores with SOFA score for predicting mortality in adult sepsis and septic shock patients admitted to intensive care unit. Heart Lung. 2019;48(3).240-4.
  • Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020.
  • Lippi G,Wong J,Henry BM, et al. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130(4):304–9.
  • Williamson EJ, Walker AJ, Bhaskaran K, et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature. 2020:1–11.
  • Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017–32.
  • Gong Y, Ding F, Zhang F, et al. Investigate predictive capacity of in-hospital mortality of four severity score systems on critically ill patients with acute kidney injury. J Investig Med. 2019;67(8):1103–9.
  • Wang H, Kang X,Shi Y, et al. SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy. Ren Fail. 2020 Nov;42(1):638-45.

COVID-19 Tanısı Alıp Yoğun Bakımda Takip Edilen Sürekli Renal Replasman Tedavisi İhtiyacı Olan Hastaların APACHE-II ve SOFA Skoru ile Değerlendirilmesi

Year 2023, Volume: 18 Issue: 3, 69 - 77, 20.11.2023

İrem Akın Şen Şenol Arslan Cem Şen

https://doi.org/10.17517/ksutfd.1164300

Abstract

Amaç: Dünya Sağlık Örgütü (DSÖ) tarafından Aralık 2019 yılında pandemi ilan edilen COVID-19 salgını sonrası, Mart’ın ikinci haftasından itibaren ülkemizde olgular bildirilmiştir. COVID-19 olgularının %5’inde hastalığın seyri sırasında yoğun bakım ünitesine (YBÜ) yatış ihtiyacı gelişmektedir. Bu çalışma ile YBÜ’de izlediğimiz kritik durumdaki COVID-19 hastalarından sürekli renal replasman (CRRT) tedavisi ihtiyacı olan hastaların mortalite oranlarını APACHE-II ve SOFA skoru ile değerlendirmesi amaçlanmıştır.
Gereç ve Yöntemler: Mart–Eylül 2020 arasında Eğitim Araştırma Hastanesinin Anestezi Yoğun Bakım Ünitesine yatırılıp CRRT ihtiyacı olan 13 hasta APACHE-II ve SOFA skorlama sistemi ile değerlendirildi. CRRT uygulamasından önce ve uygulamadan 2 gün sonra APACHE-II ve SOFA skorları kaydedildi. Mortalite açısından skorlama sistemleri kıyaslandı.
Bulgular: CRRT öncesi ve sonrası APACHE-II ve SOFA skorlama sitemlerine bakıldığında; CRRT öncesi APACHE-II skorlama sisteminin tahmini ölüm oranın öngörmede daha belirleyici olduğu; fakat CRRT sonrası APACHE-II ve SOFA skorlama sisteminin birbiriyle farkı olmadığı görülmüştür. Hastanede yatış süreleri değerlendirildiğinde APACHE-II ile SOFA skorlama sistemi arasında negatif yönde bir ilişki bulunmuştur.
Sonuç: Çalışmamız literatür ile uyumlu olarak erkeklerde ve hipertansiyonu olan hastalarda mortalitenin daha yüksek olduğunu göstermiştir. Ayrıca APACHE-II ve SOFA skoru arasında CRRT sonrasında mortalite açısından fark olmadığını her iki sisteminde kullanılabileceğini gösterilmiştir. Bu sonuçların gelecekteki takip ve tedavi yöntemlerine katkı sağlayabileceği düşünülmekle birlikte yeni çalışmalara ihtiyaç vardır.

Keywords

CCRT, APACHE-II ,SOFA SKORU COVİD 19

References

  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
  • Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50:489-94.
  • Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA. 2020;323:1239-42.
  • Shang Y, Pan C, Yang X, Zhong M, Shang X. Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China. Ann Intensive Care. 2020;10:73. https:// doi.org/10.1186/s13613-020-00689-1
  • Varatharaj A, Thomas N, Ellul MA, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020;7:875-82.
  • Berlin DA, Gulick RM, Martinez FJ. Severe COVID-19. N Engl J Med. 2020;383:2451-60. https://doi. org/10.1056/NEJMcp2009575
  • Wang D,Hu B,Hu C et. al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-9.
  • Haertel F, Reisberg D, Peters M, et al. Prognostic value of tissue oxygen saturation using a vascular occlusion test in patients in the early phase of multiorgan dysfunction syndrome. Shock. 2019;51(6):706–12.
  • Hoste EA, Clermont G, Kersten A, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care. 2006;10:R73-R73.
  • Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C, An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med. 2006;34:1913-7.
  • Uchino S, Kellum JA, Bellomo R, et al.Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813-8.
  • Schwartz RD, Messana JM, Orzol, FK Port. Comparing continuous hemofiltration with hemodialysis in patients with severe acute renal failure. Am J Kidney Dis. 1999; 34: 424–32.
  • Kresse S, Schlee H, Deuber HJ, Koall W. Osten B. Influence of renal replacement therapy on outcome of patients with acute renal failure. Kidney Int Suppl. 1999; 56: 75–8.
  • Guerin C, Girard R, Selli JM, Louis A.Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care unit; results from a multicentre prospective epidemiological survey. Intensive Care Med. 2002; 28:1411–8.
  • Chang JW, Yang WS, Seo JW, Lee JS, Lee SK, Park SK. Continuous venovenous hemodiafiltration versus hemodialysis as renal replacement therapy in patients with acute renal failure in the intensive care unit. Scand J Urol Nephrol. 2004; 38(5): 417–21.
  • Cho KC, Himmelfarb J, Paganini E, et al. Survival by dialysis modality in critically ill patients with acute kidney injury. J Am Soc Nephrol. 2006; 17(11): 3132–8.
  • Mica L, Furrer E, Keel M, Trentz O. Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients. Eur J Trauma Emerg Surg. 2012;38(6):665–71.
  • Huang W, Qin S, Sun Y, et al. Establishment of multiple organ dysfunction syndrome early warning score in patients with severe trauma and its clinical significance: a multicenter study. Zhonghua Wei Zhong Bing Jiu Xue. 2018;30(1):41–6.
  • Bahtouee M, Eghbali SS, Maleki N, et al. Acute physiology and chronic health evaluation II score for the assessment of mortality prediction in the intensive care unit: a single-centre study from Iran. Nurs Crit Care. 2019;24(6):375–80
  • Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801–10.
  • Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8:506-17.
  • Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475- 81.
  • Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically Ill patients in the seattle regioncase series. N Engl J Med. 2020;382:2012-22.
  • Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the lombardy region, Italy. JAMA. 2020;323:1574-81.
  • Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180:934-43.
  • Ko H, Yan M, Gupta R, et al.Predictors of survival in patients with advanced gastrointestinal malignancies admitted to the intensive care unit. Oncologist. 2019;24(4):483–90.
  • Tee YS, Fang HY, Kuo IM, Lin YS, Huang SF, Yu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018;97(7):e9654.
  • Khwannimit B, Bhurayanontachia R, Vattanavanit V. Comparision of the accuracy of three early warning scores with SOFA score for predicting mortality in adult sepsis and septic shock patients admitted to intensive care unit. Heart Lung. 2019;48(3).240-4.
  • Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020.
  • Lippi G,Wong J,Henry BM, et al. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130(4):304–9.
  • Williamson EJ, Walker AJ, Bhaskaran K, et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature. 2020:1–11.
  • Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017–32.
  • Gong Y, Ding F, Zhang F, et al. Investigate predictive capacity of in-hospital mortality of four severity score systems on critically ill patients with acute kidney injury. J Investig Med. 2019;67(8):1103–9.
  • Wang H, Kang X,Shi Y, et al. SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy. Ren Fail. 2020 Nov;42(1):638-45.
There are 34 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Araştırma Makaleleri
Authors

İrem Akın Şen 0000-0002-5402-4636

Şenol Arslan 0000-0002-6636-5307

Cem Şen 0000-0002-7342-1354

Early Pub Date November 10, 2023
Publication Date November 20, 2023
Submission Date August 19, 2022
Acceptance Date September 2, 2022
Published in Issue Year 2023 Volume: 18 Issue: 3

Cite

AMA Akın Şen İ, Arslan Ş, Şen C. COVID-19 Tanısı Alıp Yoğun Bakımda Takip Edilen Sürekli Renal Replasman Tedavisi İhtiyacı Olan Hastaların APACHE-II ve SOFA Skoru ile Değerlendirilmesi. KSU Medical Journal. November 2023;18(3):69-77. doi:10.17517/ksutfd.1164300
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