Uğur Önal

and 16 more

Background: Determination of the prognostic factors which affects the mortality and morbidity in COVID-19 patients, has an importance in terms of planning the treatment and follow-up strategy. Material and Method: Patients who had COVID-19 diagnosis via microbiologically and/or radiologically between March and October 2020 in a tertiary-care university hospital were recorded retrospectively. Only adult patients (≥18 years) with clinical spectrum of moderate, severe and critical illness were included in the study according to National Institutes of Health (NIH) guideline. A p value of less than 0.05 was considered significant. Ethical committee approval was given from the Uludag University with decision number 2020-22/11. Also, the permission from Republic of Turkey, Ministry of Health was given. Results: A total number of 257 patients were included in the study. 30-day mortality rate was recorded as 14.4%. In univariate analysis; age, chronic renal failure, malignancy, cerebrovascular disease, number of comorbidities >2, dyspnea, cough, NIH severe and critical illness, oxygen saturation, respiratory rate, systolic and diastolic blood pressure, qSOFA, GCS, MEWS, SOFA, CURB-65, CCI, CRP, procalcitonin, CK, D-dimer, lymphocyte and thrombocyte levels, neutrophile-to-lymphocyte ratio, AST, albumin, hemoglobin, CK-MB, fibrinogen, LDH and potassium levels were found as statistically significant (p<0.05). In logistic regression analysis one point increase of SOFA (p<0.001, OR:1.861, 95%CI:1.403-2.468) and CURB-65 scores (p=0.002, OR:2.484, 95%CI:1.401-4.406) were found as statistically significant for 30-day mortality. In mortal patients, there were significant difference between the baseline, day 3, 7 and 14 results of D-dimer (p=0.01), Ferritin (p=0.042), leucocyte (p=0.019) and neutrophile count (p=0.007). Conclusion: In our study, SOFA and CURB-65 scores on admission were associated with mortality and these score systems might be useful tools for the prognosis in COVID-19 patients.In addition to this, D-dimer, Ferritin, leucocyte and neutrophile counts were significantly increased during the follow up in patients with mortality.

Derya Karasu

and 5 more

Background: The aim of this study was to investigate the effect on the occurrence of emergence delirium of propofol and ketofol with intranasal dexmedetomidine and midazolam applied as premedication to paediatric patients during magnetic resonance imaging (MRI). Methods: The study included children aged 2-10 years who received sedation for MRI, separated into four groups. Group MP received intranasal midazolam (0.2 mg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group MK received intranasal midazolam (0.2 mg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. Group DP received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group DK received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. The Paediatric Anaesthesia Emergence Delirium (PAED) scale was used to evaluate delirium. A PAED score ≥ 10 was accepted as delirium. Results: The need for additional anaesthetic was highest in Group DP at 94.3% and lowest in Group DK at 14.3%. The mean Aldrete and PAED scores were lower and the length of stay in the recovery room was shorter in Group DP than in the other groups. Delirium only developed in two patients in Group MP (5.7%) at 5 mins after anaesthesia. Conclusion: In our study, delirium was seen at a very low rate only in the Group MP and it is difficult to say the best combination in terms of delirium frequency with this result.