MORTALITY RISK ASSESSMENT AMONG PATIENTS, HOSPITALIZED FOR COVID-19.

In Georgia, the number of confirmed cases of Coronavirus were 1,85,5289. Among them, 17 132 patients died. Information on risk factors for mortality is insufficient. The purpose of our research is to evaluate clinical features of heavy patients with severe COVID and determine prognostic factors of outcome. Factors associated with critical COVID-19 included older age and certain chronic medical conditions. The clinical material of 250 chronically ill COVID-19 patients admitted to the intensive care unit was retrospectively studied. We divided the patients into two groups. The dead and the survivors. Demographic data, comorbidities, chronic diseases, results of ultrasound, cardiography, computed tomography and laboratory characteristics were studied. In patients with chronic diseases, in the intensive care unit during COVID-19, the relative chance of survival decreases: CRP3 - OR=0.98(95% CI:0.97-0.99Hydrothorax- OR=0.24(95% CI:0.06-0.95); Sepsis/Septic shock - OR=0.07(95% CI:0.01-0.39); WBC - OR=0.86(95% CI:0.74-0.99); Mechanical lung ventilation - OR=0.01(95% CI:0.00-0.05)); increase survival relative chance- pO2 - OR=1.03(95% CI:1.0-1.06). Predictors of mortality in patients with chronic diseases: coagulation characteristics, inflammatory markers, sepsis, and artificial lung ventilation. Risk factors for covid-19 mortality need to be studied to increase pandemic preparedness.

STUDY OF INTRAOPERATIVE INDOCYANINE GREEN ANGIOGRAPHY EFFECTIVENESS FOR IDENTIFICATION OF PARATHYROID GLANDS DURING TOTAL THYROIDECTOMY.

Postoperative hypocalcemia is a common complication of thyroidectomy. This problem is most often associated with accidental devascularisation or excision of the parathyroid glands (PG). Aim was study near-infrared fluorescent imaging with intraoperative parathyroid gland indocyanine green angiography to help identify and preserve parathyroid glands during total thyroidectomy in order to avoid postoperative hypocalcemia. For period from 2017 to 2019 years, 58 patients in Odessa regional hospital were underwent total thyroidectomy. Indications for surgery were multinodular goiter (n=42), thyroid cancer (n=11) and Graves' disease (n=5). By randomization all patients were divided into two groups: in the first group, 28 patients underwent standard total thyroidectomy, in the second group 30 patients underwent near-infrared-assisted total thyroidectomy with indocyanine green (ICG) angiography. Parathyroid autofluorescence was detected using a near infrared/indocyanine green endoscopic system (Karl Storz, Germany). Serum calcium and parathyroid hormone levels were compared between the two groups of patients in 1, 7 -15 days after surgery and then 3, 6 months later. In the first group, on based of a visual assessment of the PG, autotransplantation the PG were conduct in only 4 cases (in 3 cases - one gland, in one case - 2 glands). In the second group, autotransplantation was performed in 11 patients (in 8 cases - one gland, in 2 cases - two, in one case - 3). The transient postoperative hypocalcemia was observed in 5 patients of the first group (17,86%) and in the 2 patients of second group (6,67%) on 5-10 postoperative days. In the first group 1 patient at 3 months after surgery had permanent hypocalcemia. Near-infrared fluorescent imaging with intraoperative parathyroid gland indocyanine green angiography is a safe and an easily repeatable method. This technique provides improved detecting and assessment of the perfusion of the PG. The need for autotransplantation of the PG can be determined more objectively using ICG imaging than simple visualization.