The clinical characteristics and the risk factors for mortality in Non-COVID-19 critical patients in a pandemic hospital in Turkey: a retrospective crosssectional study

Abstract

Background
Coronavirus disease 2019 (COVID-19) disrupted standard health policies and routine medical care, and thus, the management and
treatment pathways of many clinical conditions have changed as never before. The negative impact of the pandemic rendered the
systemic disease more complicated and accelerated mortality. For the last two years, clinicians have primarily focused on COVID-19
patients; however, the non-COVID-19 critically ill patients needed to be addressed from multiple perspectives. This study investigated
the demographic and clinical characteristics of non-COVID-19 critical care patients admitted concurrently with a COVID-19 wave.
The objective of this study was to identify the risk factors for mortality in critically ill non-COVID-19 patients.
Methods
All consecutive cases admitted to the intensive care unit (ICU) were included in the study between January 1, 2021 and July 14, 2021.
All data, including age, gender, admission characteristics, patient dependency, pre-existing systemic diseases, the severity of illness
(Acute Physiology and Chronic Health Evaluation –APACHE-II), predicted death rate in ICU, life-sustaining medical procedures on
admission or during ICU stay, length of stay, and admission time to the ICU, were obtained from the hospital’s electronic database. The
Charlson Comorbidity Index (CCI) was assessed for all patients.
Results
A total of 192 patients were screened during the study period. Mortality was significantly increased in non-surgical patients, previously
dependent patients, patients requiring mechanical ventilation, continuous renal replacement therapy, and patients requiring the infusion
of vasoactive medications. The number of pre-existing diseases and the admission time had no impact on mortality. The mean CCI
was significantly higher in non-survivors but was not a strong predictor of mortality as APACHE II.
Conclusions
In this retrospective study, the severity of illness and the need for vasoactive agent infusion were significantly higher in non-survivors
confirmed by multivariate analysis as predictive factors for mortality in critical non-COVID-19 patients.