Solunumsal Yoğun Bakım Ünitesi'nde mortaliteyi etkileyen faktörler
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Tarih
2015
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info:eu-repo/semantics/closedAccess
Özet
Amaç: Bu çalışmanın amacı Solunumsal Yoğun Bakım Ünitesi (SYBÜ)'ne yatan hastaların 37 klinik ve laboratuar parametreleri ile Glasgow Koma Skalası, Acute Physiology Assessment and Chronic Health Evaluation II (APACHE II) ve Sequential Organ Failure Assessment (SOFA) değerlerini exitus olan ve yaşayan hastalar arasında karşılaştırarak mortaliteyi etkileyen faktörleri saptamaktır. Metod: Üniversitemiz Göğüs Hastalıkları ve Tüberküloz kliniğinin 9 yataklı yoğun bakım ünitesine kabul edilen 116 hastanın ilk 24 saatteki parametreleri prospektif olarak kayıt edildi. Hastaların demografik özellikleri, kan örnekleri, surveyleri ve verileri toplandı. İstatiksel olarak lojistik regresyon analizi kullanıldı. Bulgular: Çalışmamızda 116 hastada beklenen mortalite oranı %49,7 iken gerçekleşen mortalite oranı %39.6 (46 hasta) olarak hesaplandı. APACHE II skoru, Glasgow Koma Skalası, SOFA skoru, pH, laktat, FiO2, üre, ALT, AST, T.Protein, albumin, T.Bilirubin, D.Bilirubin, PTZ ve INR değerleri exitus olan ve yaşayan hastalar arasında anlamlı farklılık saptandı. Sonuç: Hastaların YBÜ'ne kabulde beklenen mortaliteleri değerlendirildiğinde, hastalarda solunum yetmezliği varlığının yanı sıra, karaciğer fonksiyon bozukluğu, metabolik bozukluklar gibi komorbiditelerin olmasının mortalitenin yüksek seyretmesinde katkıda bulunabileceğini düşündürmektedir. Anahtar Sözcükler: Yoğun bakım, mortalite, prognoz, skorlama sistemleri.
Aim: The aim of present study was to compare routine clinical and laboratory parameters, acute physiologic and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) and Glasgow coma score (GCS) for their value between alive and exitus patients during hospital stay in patients admitted to respiratory intensive care unit. Method: A prospective observational clinical study was carried out in a 9-bed Respiratory Intensive Care Unit of Chest Disease and Tuberculosis Clinic in Dicle University Medical Faculty. One hundred and sixteen patients were observed. Laboratory parameters and scoring points for first 24 hour were noted. Patients? demographic specialties, laboratory parameters, hospital staying days, GCS, APACHE II and SOFA scores data collection were performed. We used logistic regression to compare parameters and scores. Results: Mortality rate was 39.6 % (46 Patients) of 116 patients, despite expected mortality rate 49.7 %. APACHE II scores, SOFA scores, GCS?s, pH, lactate, FiO2, urea, ALT, AST, total protein, albumine, total bilirubine, direct bilirubine, PTT and INR parameters had meaningful differences between alive and exitus patients groups. Conclusion: Co-morbidities such as hepatic dysfunction and metabolic disorders beside respiratory failure have additional contribution for increased mortality risk for patients who are admitted respiratory intensive care units. Key words: intensive care, mortality, prognosis, scoring systems.
Aim: The aim of present study was to compare routine clinical and laboratory parameters, acute physiologic and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) and Glasgow coma score (GCS) for their value between alive and exitus patients during hospital stay in patients admitted to respiratory intensive care unit. Method: A prospective observational clinical study was carried out in a 9-bed Respiratory Intensive Care Unit of Chest Disease and Tuberculosis Clinic in Dicle University Medical Faculty. One hundred and sixteen patients were observed. Laboratory parameters and scoring points for first 24 hour were noted. Patients? demographic specialties, laboratory parameters, hospital staying days, GCS, APACHE II and SOFA scores data collection were performed. We used logistic regression to compare parameters and scores. Results: Mortality rate was 39.6 % (46 Patients) of 116 patients, despite expected mortality rate 49.7 %. APACHE II scores, SOFA scores, GCS?s, pH, lactate, FiO2, urea, ALT, AST, total protein, albumine, total bilirubine, direct bilirubine, PTT and INR parameters had meaningful differences between alive and exitus patients groups. Conclusion: Co-morbidities such as hepatic dysfunction and metabolic disorders beside respiratory failure have additional contribution for increased mortality risk for patients who are admitted respiratory intensive care units. Key words: intensive care, mortality, prognosis, scoring systems.
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Anahtar Kelimeler
Yoğun bakım, Intensive care, Mortalite, Mortality, Prognoz, Prognosis, Skorlama sistemleri, Scoring systems
