Title Sestrinska skrb u potpori liječenja COVID-19 bolesnika starije životne dobi - utjecaj koncentracije vitamina D na ishod bolesti
Title (english) Nursing care in support of Covid-19 treatment of elderly patients - influence of vitamin D concentration on disease outcome
Author Karla Abramušić
Mentor Daniela Šupe-Domić (mentor)
Committee member Mario Marendić (predsjednik povjerenstva)
Committee member Diana Aranza (član povjerenstva)
Committee member Daniela Šupe-Domić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2023-10-25, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Cilj istraživanja: otkriti je li moguće uz pomoć analiziranih laboratorijskih parametara predvidjeti ishod bolesti COVID-19 kod starije populacije.
Izvori podataka i metode: U istraživanju je sudjelovalo 176 ispitanika, odnosno osoba starijih od 60 godina koji su bili hospitalizirani u jedinici intenzivne njege KBC-a Split zbog COVID-19 infekcije, od čega je 63 umrlih te 113 preživjelih pacijenata. Venepunkcija uzoraka seruma izvršena je u skladu s Nacionalnim preporukama za uzorkovanje venske krvi. Razine vitamina D analizirane su imunokemijskom elektrokemoluminiscentnom metodom. Analiza svih prikupljenih podataka obavljena je korištenjem računalnog programa MedCalc, a stupanj statističke značajnosti postavljen je na p < 0.05.
Rezultati: Istraživanje je pokazalo da postoji statistički značajna razlika između preminulih i umrlih s obzirom na dob (p=0.016), razinu vitamina D (p<0.001), razinu kalcija (p<0.001) te razinu magnezija (p=0.001). Razina vitamina D statistički je značajno viša kod preživjelih u usporedbi s preminulim pacijentima (22.8 ± 20.8 vs. 36.6 ± 22.8; p< 0.001). Razina GDF-15 također je viša kod preživjelih, ali ta razlika nije statistički značajna. Pokazalo se da postoji statistički značajna povezanost između razina magnezija i kalcija te ishoda bolesti COVID-19 kod starije populacije, ali ne i statistički značajna povezanost razina fosfora te broja leukocita, neutrofilnih granulocita, limfocita i trombocita te ishoda bolesti. Statistička obrada ukazala je na povezanost GDF-15 i magnezija (u ukupnom uzorku, u skupini preživjelih i umrlih), fosfora (u ukupnom uzorku te u skupini preživjelih) te kalcija (u skupini preminulih). Pokazalo se i da postoji korelacija između vitamina D i kalcija (u ukupnom uzorku, u skupini preživjelih i umrlih) te magnezija (u ukupnom uzorku i u skupini preminulih), dok nije uočena povezanost s fosforom. Multivarijabilna logistička regresijska analiza pokazala je da je samo razina vitamina D snižena kod starijih pacijenata s COVID-19 infekcijom (OR 1.047, 95% CI 1.020 - 1.075; p<0.001) kada se stavi u model s dobi te razinama GDF-15 i katestatina i brojem leukocita.
Zaključak: Ishod bolesti COVID-19 lošiji je što je pacijent stariji i što je koncentracija vitamina D u krvi pacijenta niža. Na ishod bolesti mogu utjecati i razine magnezija i kalcija, ali bi njihovu korelaciju s ishodom bolesti COVID-19 trebalo detaljnije ispitati.
Abstract (english) Master thesis title: Nursing care in support of C-19 treatment of elderly patients – influence of vitamin D concentraton on disease outcome
Objectives: To investigate is it possible to predict the outcome of the disease of COVID-19 in the elderly population with the help of analyzed laboratory parameters.
Data sources and methods: The research involved 176 respondents, i.e. people over 60 years old who were hospitalized in the intensive care unit of KBC Split due to COVID-19 infection, of which 63 died and 113 survived. Venipuncture of serum samples was performed in accordance with the National Recommendations for Venous Blood Sampling. Vitamin D levels were analyzed by Roche immunochemical electrochemoluminescent method. The analysis of all collected data was performed using the MedCalc computer program, and the level of statistical significance was set at p < 0.05.
Results: The research showed that there is a statistically significant difference between the deceased and the deceased with regard to age (p=0.016), vitamin D level (p<0.001), calcium level (p<0.001) and magnesium level (p=0.001). The level of vitamin D is statistically significantly higher in survivors compared to deceased patients (22.8 ± 20.8 vs. 36.6 ± 22.8; p< 0.001). The level of GDF-15 is also higher in survivors, but this difference is not statistically significant. It was shown that there is a statistically significant relationship between the levels of magnesium and calcium and the outcome of the disease of COVID-19 in the elderly population, but not a statistically significant relationship between the levels of phosphorus and the number of leukocytes, neutrophil granulocytes, lymphocytes and platelets and the outcome of the disease. Statistical processing indicated a connection between GDF-15 and magnesium (in the total sample, in the group of survivors and deceased), phosphorus (in the total sample and in the group of survivors) and calcium (in the group of deceased). It was also shown that there is a correlation between vitamin D and calcium (in the total sample, in the group of survivors and deceased) and magnesium (in the total sample and in the group of the deceased), while no connection was observed with phosphorus. Multivariable logistic regression analysis showed that only vitamin D level in elderly patients with COVID-19 infection is lowered (OR 1.047, 95% CI 1.020 - 1.075; p<0.001) when put into the model with age and GDF-15 and catestatin levels and the number of leukocytes.
Conclusion: The outcome of the disease of COVID-19 is worse the older the patient and the lower the concentration of vitamin D in the patient's blood. Magnesium and calcium levels can also affect the outcome of the disease, but their correlation with the outcome of the disease of COVID-19 should be examined in more detail.
Keywords
COVID-19
vitamin D
starija životna dob
prediktor
Keywords (english)
COVID-19
vitamin D
older age
predictor
Language croatian
URN:NBN urn:nbn:hr:176:073955
Study programme Title: Nursing (university/graduate) Study programme type: university Study level: graduate Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Access restricted to students and staff of home institution
Terms of use
Created on 2023-10-25 13:33:50