PT  - JOURNAL ARTICLE
AU  - Hayriye C. Dal
AU  - Betul A. Dolek
AU  - Muhammet A. Beyoğlu
AU  - Dilek Acar
AU  - Melih G. Gozukara
AU  - Sema Turan
TI  - Evaluation of diaphragm thickness to predict intubation requirement and mortality in critical COVID-19 patients
AID  - 10.15537/smj.2022.43.10.20220469
DP  - 2022 Oct 01
TA  - Saudi Medical Journal
PG  - 1120--1127
VI  - 43
IP  - 10
4099  - http://smj.org.sa/content/43/10/1120.short
4100  - http://smj.org.sa/content/43/10/1120.full
SO  - Saudi Med J2022 Oct 01; 43
AB  - 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’ 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.