@article {Dal1120, author = {Hayriye C. Dal and Betul A. Dolek and Muhammet A. Beyo{\u g}lu and Dilek Acar and Melih G. Gozukara and Sema Turan}, title = {Evaluation of diaphragm thickness to predict intubation requirement and mortality in critical COVID-19 patients}, volume = {43}, number = {10}, pages = {1120--1127}, year = {2022}, doi = {10.15537/smj.2022.43.10.20220469}, publisher = {Saudi Medical Journal}, abstract = {Objectives: To investigate the value of measuring the diaphragm thickness (DT) on thorax computed tomography (CT) at intensive care unit (ICU) admission for predicting intubation requirement and mortality among COVID-19 patients.Methods: This study was carried out in Ankara City Hospital, Ankara, Turkey, from September 2020 to January 2021, with 94 critical COVID-19 patients. The patients{\textquoteright} demographic characteristics, laboratory parameters, DT measurements, mechanical ventilation (MV) requirements, and mortality statuses were retrospectively screened. The relationships between DT on initial CT, MV requirement, and mortality were investigated.Results: Diaphragm thickness was lower in patients who required intubation after ICU admission than in non-intubated patients (p=0.006); it was also lower in non-survivors (p=0.009). The threshold values for MV need was 3.35~mm (p=0.004) and 3.275~mm for mortality (p=0.006), according to the receiver operating characteristic analysis used to assess the predictive potential of DT. The non-survivor group had a greater neutrophil-to-lymphocyte ratio (p=0.026). Absolute neutrophil count (p=0.017), neutrophil-to-lymphocyte ratio (p=0.010), and interleukin-6 levels (p=0.027) were higher among patients requiring MV than among non-intubated patients.Conclusion: Mortality and MV requirements can be predicted from DT measurements. Diaphragm thickness can facilitate the identification of high-risk patients on CT evaluation at ICU admission.}, issn = {0379-5284}, URL = {https://smj.org.sa/content/43/10/1120}, eprint = {https://smj.org.sa/content/43/10/1120.full.pdf}, journal = {Saudi Medical Journal} }