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COVID-19 hastalarının hastanede kalış süreleri ve kalış sürelerini etkileyen faktörlerin belirlenmesi hastane yönetimi için önem arz etmektedir. Tokat Devlet Hastanesin’e başvuran 3184 COVID-19 hastası hastaneye gelişlerinde muayene edilip ayakta veya yatarak tedavi edilmelerine göre kategorize edildiler. Basit, koşullu ve yarışan riskler için Cox orantılı hazard modeli kullanılarak, hem genel olarak ve hem de hastanın yaşı veya hayatta kalma süresi bir faktörün ölüm oranına ve taburcu olma durumuna katkısı dikkate alınarak, hastanede kalış sürelerini etkileyen faktörler incelendi. Hayatta kalan Yoğun Bakım Ünitesi hastalarının, hayatta kalmayan Yoğun Bakım Ünitesi hastalarına ve Yoğun Bakım Ünitesi olmayan hastalara göre daha uzun hastanede kalış süresine sahip olduğu bulgulandı. Artan yaşın, hastanede daha uzun kalış süresiyle ilişkili olduğu gözlemlendi. Yüksek C-reaktif protein (CRP), düşük hemoglobin (HGB) ve kalsiyum seviyelerinin, hayatta kalma durumunun katkısından bağımsız olarak, hastanede daha uzun kalma süresiyle ilişkili olduğu belirlendi. Çalışmamızda hemen hemen bütün faktörlerin daha hızlı / daha yavaş ölüm veya taburcu olma oranına katkıda bulunduğu gözlemlenmiştir. Ayrıca, glukozun, hastanede kalış süresi ile ilgili olarak, HbA1C veya diyabet durumundan daha önemli olduğu gözlemlendi. Bu bulguların, daha iyi bir hastane yatak yönetimi için kullanılabileceğini düşünmekteyiz.
Identification of the factors affecting the hospitalization periods and the hospitalization periods of COVID-19 patients is of importance for the hospital management. 3184 COVID-19 patients who were applied to the Tokat State Hospital were categorized according to their examination and treatment when they arrived at the hospital, standing or lying. For simple, conditional and competing risks, using the Cox-proportionate hazard model, both in general and taking into account the contribution of a factor to the mortality rate and the state of departure of the patient's age or survival, the factors that affect the duration of hospital stay were studied. It was found that the surviving Patients of the Intensive Care Unit had a longer stay in the hospital than the surviving Patients of the Intensive Care Unit and the non-Intensive Care Unit. The increase in age has been observed associated with the longer stay in the hospital. High C-reactive protein (CRP), low hemoglobin (HGB) and calcium levels, regardless of the contribution of survival, were found to be associated with longer stay in the hospital. In our study, it has been observed that almost all factors contribute to the faster / slower rate of death or departure. It was also observed that glucose was more important in relation to the duration of stay at the hospital than HbA1C or diabetes. We think these findings can be used for a better hospital bed management.
Knowing the typical length of hospital stay of COVID-19 patients and which factors affecting the stay time is important for hospital management. 3184 COVID-19 patients from the Tokat State Hospital collected from were examined on arrival to the hospital and were either treated as inpatients, or as outpatients. By using simple, conditional and cause-specific Cox proportional-hazard regressions for competing risk, we examined factors impacting hospital stay time, both overall and by taking into account patient’s age or survival status and contribution from a factor to the rate of event of mortality, and to the event of discharge. Surviving ICU patients have longer hospital stay time than non-surviving ICU patients, which is longer than non-ICU patients. Older age is correlated with a longer hospital stay. Increased C-reactive protein (CRP), decreased hemoglobin (HGB) and calcium levels are associated with longer hospital stay, independent from the contribution from surviving status. Almost all factors we collected contribute to a faster/slower mortality or discharge rate. We also observed that glucose is more important than HbA1C or diabetes status in its influence on hospital stay time. This information could be used for a better hospital bed management.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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