RT Journal Article
SR Electronic
T1 Evaluation of diaphragm thickness to predict intubation requirement and mortality in critical COVID-19 patients
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1120
OP 1127
DO 10.15537/smj.2022.43.10.20220469
VO 43
IS 10
A1 Hayriye C. Dal
A1 Betul A. Dolek
A1 Muhammet A. Beyoğlu
A1 Dilek Acar
A1 Melih G. Gozukara
A1 Sema Turan
YR 2022
UL http://smj.org.sa/content/43/10/1120.abstract
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.