Results
The mean age of the 48 patients included in the study was 57.6±17.6 years. Twenty-two of the patients were women (mean age 55.8±18.3 years) and 26 were men (mean age 59.1±17.3 years). Twenty-eight of the patients had HT, 12 had DM, 4 had asthma, and 1 had epilepsy. Body mass index (BMI) was > 30 kg/m2 in 15 of the patients. Of 26 patients who developed ARDS, 20 had HT, 8 had DM, 1 had epilepsy, and 6 had BMI > 30 kg/m2. Of the patients who developed MAS, 10 had HT, 4 had DM, and 1 had epilepsy.
In the physical examination performed at hospital admission, mean respiratory rate (breaths/minute) was 21.4 ± 12.3 among patients who later developed MAS, 24.6 ± 13.4 among patients who developed ARDS, and 15.4 ± 4.8 in patients without ARDS and MAS. Comparison of patients with and without ARDS and MAS showed that respiratory rate was statistically significantly higher in the ARDS and MAS groups (p=0.001, p=0.001). On day 5 of treatment, the mean respiratory rate was 18.4 ± 4.5 in the MAS group, 20.1 ± 5.6 in the ARDS group, and 14.4 ± 3.6 in the group of patients without MAS or ARDS.
A comparative analysis of the patients’ laboratory parameters at hospital admission and on day 5 of treatment is shown in Table 1. When patients with and without MAS were compared in terms of their COHb levels at admission and on day 5 of treatment, it was found that patients who developed MAS had lower COHb level at admission (p=0.002). Comparison of the changes in COHb levels over the course of 5 days showed a statistically significant increase in patients who developed MAS (Figure 1) (p=0.001). When patients with and without ARDS were compared in terms of COHb levels at admission, it was found that COHb level was significantly lower at admission but higher on day 5 (p=0.001, p=0.001). As in the patients who developed MAS, COHb levels increased further over the course of 5 days in patients who developed ARDS (Figure 1) (p=0.001). Changes in other laboratory parameters in patients who developed MAS and ARDS are shown in Tables 2 and 3. Comparison of COHb levels between deceased (n=4) and surviving patients (n=44) showed that in deceased patients, COHb levels were significantly lower at admission and higher on day 5 of treatment (p=0.04, p=0.001).
In the correlation analysis between COHb level and laboratory parameters and demographic data, moderate negative correlations were detected between COHb level and CRP (r=-0.425, p=0.001), ferritin (r=-0.395, p=0.001) (Figure 2), and age (r=-0.314, p=0.001). Moderate positive correlations were detected between COHb and lymphocyte count (r=0.43, p=0.001) (Figure 2) and PaO2/FiO2(r=0.431, p=0.001). There was also a weak negative correlation between COHb and troponin-I level (r=-0.287, p=0.05).
In correlation analysis between COHb level on day 5 of treatment and laboratory parameters, a moderate positive correlation was detected between COHb level and CRP (r=0.55, p=0.001), prothrombin time (r=0.387, p=0.001), and creatinine (p=0.408, p=0.001), but no significant difference was detected in other parameters at time of admission.