Medical and Health Sciences

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https://hdl.handle.net/20.500.11888/18295

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Browsing Medical and Health Sciences by Author "Fadi Saliba Jeries Assi"

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    SURVIVAL RATE AND OUTCOMES AMONG CRITICALLY ILL COVID-19 PATIENTS REQUIRING INVASIVE MECHANICAL VENTILATION (IMV) IN PALESTINE
    (2022-07-26) Fadi Saliba Jeries Assi
    ABSTRACT Introduction: COVID-19 is a respiratory infectious disease and can deteriorate to ARDS and respiratory failure, which necessitates the need of invasive mechanical ventilation. The varying treatment strategies and outcomes warrant the need to further explore patient characteristics and treatment plans, and their potential associations with morbidity and mortality. Aim: To designate the survival rate and outcomes of COVID-19 patients who underwent IMV, as well as impact of their clinical characteristics and treatment strategies. Method: A retrospective observational cohort design. All COVID-19 patients who were admitted to targeted hospitals between 1/8/2020 to 30/4/2021, older than 18 years and required IMV were enrolled. Data was gathered from the hospital information system and include Characteristics (demographic data, comorbidities, lab values), Treatment strategies (respiratory support, proning, intubation timing, mechanical ventilator settings and pharmacological treatments) and Outcomes (complications, length of stay on IMV, and mortality). Comparisons were then drawn between two subsets divided by mortality using the variables mentioned above using SPSS. Results: 150 patients required IMV which represents 39.8% of COVID-19 patients and 13 (8.7%) of which survived to hospital discharge. The mean age was 64 years old and younger age was associated with lower mortality (OR 0.948, p=0.006). Cardiovascular Disease and peak creatinine were significantly higher in deceased patients (p=0.041, p=0.008) respectively. Patients who underwent pressure mode ventilation, with lower FiO2 and inspiratory pressure had a higher rate of survival (OR 4.416, 0.883, 0.478, respectively, p<0.05), as well as who were submitted to tracheostomy. Remedsivir had a significant correlation with survival (p-value=0.001). ICU median length of stay was 27 days for patients who survived and 11 for those who died (p-value <0.001), while IMV median LOS for survivors and deceased patients was 15 days vs. 6 days, respectively (p-value <0.001). Patients developed complications such as AKI (60.7%) and cardiovascular (45.3%) which are significantly correlation with deceased patients. Conclusion: Survival rate among COVID-19 patients who underwent IMV was low (8.7%). Evidence based practice and multidisciplinary management are recommended in treatment of critically ill COVID-19 patients depending on research, to improve their outcomes. Keywords: COVID-19, IMV, Mortality, Characteristics, Survival rate, Outcomes.