Bir üniversite hastanesine KOAH alevlenme ile yatan hastaların genel özelliklerinin incelenmesi

Amaç: Kronik Obstrüktif Akciğer Hastalığı (KOAH) önemli bir morbidite ve mortalite nedenidir. Hastanede yatışların, hastalığın ağırlığını gösteren parametreler ile ilişkili olduğu bilinmektedir. Çalışmamızın amacı üniversite hastanesine KOAH akut atağı ile hastane yatışı gereken hastaların genel özelliklerinin incelenmesi ve hastane yatış süresine etki eden faktörlerin saptanmasıdır.Materyal ve Metod: Çalışmamızda 2015-2018 yıllarında Harran Üniversitesi Tıp Fakültesi Hastanesine KOAH akut atağı ile yatan hastalar retrospektif olarak incelendi. Bu hastaların sosyodemografik verileri, hastalık evreleri, hemogram, biyokimya, c-reaktif protein düzeyleri ile hastanede yatış süreleri veri formuna kaydedildi. Çalışmaya dahil edilme kriterleri, 40 yaş üstü KOAH tanılı hastalar iken, çalışmadan dışlama kriterleri astım, bronşektazi gibi diğer obstrüktif akciğer hastalıkları, kendi isteği ile taburcu olan hastalar olarak belirlendi. KOAH tanısı ve evrelemesi için Global Initiative for Chronic Obstructive Lung Disease (GOLD) rehberleri temel alındı.Bulgular: Çalışmamıza ortalama yaşı 68,1±10,7 olan 29 (%24,3) kadın, 90 (%75,6) erkek toplam 119 hasta dahil edildi. Çalışmaya dahil edilen hastaların 81 (%68)’i 65 yaş ve üstündeyken, 38 (%31,9) hasta 65 yaş altına idi. Hastanede ortalama kalış süresi 9,3±6,0 gün, kadınlarda 9,8±4,9 gün erkeklerde 9,2±6,3 gün olarak saptandı. Yaşlı hastalar (≥65 yaş) 9,8±6,5 gün, genç hastalar (<65 yaş) 8,2±4,6 gün hastanede yatmıştı (p:0.175). En sık başvuru nedeni nefes darlığı (%80,6) olarak tespit edildi. Çalışmaya dahil edilen hastaların %8,4 (10) A grubu, %45,3(54) B grubu, %23.5 (28) C grubu ve %22,6 (27) D grubu olduğu gözlendi. A grubundan D grubuna doğru gidildikçe FEV1 (p:0.000), FVC (p:0.000) ve FEV1/FVC (p:0.000) düzeylerinde istatistiki olarak anlamlı düzeyde azalma tespit edildi. A grubunda eozinofil (p:0.006) düzeyinin, C grubunda ise alanin aminotransferaz (p:0.021) ve üre (p:0,026) düzeyinin diğer gruplardan istatistiki olarak anlamlı düzeyde yüksek olduğu tespit edildi.Sonuç: KOAH akut atağı ile hastaneye yatan hastaların büyük bir bölümü yaşlı erkek hastalardan oluşmaktadır. KOAH evresi ve kan üre düzeyi arttıkça hastanede kalış süresi artmaktadır.

Anahtar Kelimeler:

KOAH, Alevlenme, Hastaneye yatış

Examination of the general characteristics of patients hospitalized with acute COPD exacerbation in a university hospital

Background: Chronic Obstructive Pulmonary Disease (COPD) is an important cause of morbidity and mortality. Admission at the hospital is thought to be related to parameters indicating the severity of the disease. The aim of this study is to investigate the general characteristics of the patients who are hospitalized with acute exacerbation of COPD and to determine the factors affecting the lenght of hospitalization.Material and Methods: Patients with acute COPD exacerbation at the Harran University Medical Faculty Hospital between 2015 and 2018 were studied retrospectively. Sociodemographic data, disease stages, hemogram, biochemistry, c-reactive protein levels and lenght of stay were recorded in the data of patients with COPD acute exacerbation. Exclusion criteria were asthma, other obstructive lung diseases such as bronchiectasis, and patients who were discharged on their own voluntarily, while the study inclusion criteria were COPD patients over 40 years of age. Based on the guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for COPD diagnosis and staging.Results: A total of 119 patients (29.3%) were female and 90 (75.6%) were male, whose mean age was 68.1 ± 10.7 years. Of the patients included in the study, 81 (68.0%) were over 65 years old and 38 (31.9%) patients were under 65 years old. The mean duration of stay at the hospital was 9.3 ± 6.0 days, 9.8 ± 4.9 days for women and 9.2 ± 6.3 days for men. Elderly patients (≥65 years) were in the hospital for 9.8 ± 6.5 days and younger patients (<65 years) were in the hospital for 8.2 ± 4.6 days (p: 0.175). The most frequent symptom was dsypnea (80.6%). Of the patients included in the study, 10 (8.4%) were group A, 54 (45.3%) were from group B, 28 (23.5%) were from group C and 27 (22.6%) were from group D.nAs the severity of the disease increased, there was a statistically significant decrease in FEV1 (p: 0.000), FVC (p: 0.000) and FEV1 / FVC (p: 0.000) levels. The level of eosinophil (p:0.006) in group A and the level of alanine aminotransferase (p:0.021) and urea (p:0.026) in group C were statistically significantly higher than the other groups.Conclusion: Most of the patients hospitalized with acute exacerbation of COPD are elderly male patients. As COPD progression and blood urea levels increase, the length of stay in the hospital increases.

Keywords:

COPD, exacerbation, hospitalization charge,

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