Osman Yıldırım, Alim Erdem, Aytekin Alçelik, Fatih Canan, Serkan Öztürk, Suzi Selim Ayhan, Mehmet Fatih Özlü, Mehmet Yazıcı

Kardiyoloji Servisinde Yatan Dekompanse Sistolik Kalp Yetmezlikli Hastalarda Depresyon Sıklığı ve Prognoza Etkisi

Giriş: Kalp yetmezliği ile depresyon birlikteliği sık görülmekte olup, morbidite ve mortaliteyi artırıp, prognozu kötüleştirmektedir. Biz bu çalışmamızda dekompanse sistolik kalp yetmezliği (DSKY) tanısıyla hastanede takip edilen hastaların psikolojik durumlarını değerlendirerek bu konuda hastaya verilen medikal ve terapi desteğini saptamaya çalıştık. Materyal ve Metod: Çalışmamıza Abant İzzet Baysal Üniversitesi Tıp Fakültesi Kardiyoloji Kliniğinde New York Kalp Birliği sınıflandırma sistemi (NHYA) ile fonksiyonel sınıf II-IV DSKY tanısı ile yatırılan ve ejeksiyon fraksiyonu (EF) %40 ve altında olan toplam 71 hasta dahil edildi. Bu hastalar NHYA sistemine göre iki gruba ayrıldı (Grup A: Evre 2-3, Grup B: Evre 4). Hastaların depresyon durumları geriyatrik depresyon ölçeği (GDÖ) ile değerlendirildi. Bulgular: Yetmiş bir hastanın 21 (%29.6)'inin depresyonda olduğu görüldü. Bu hastaların 8 (%38)'i erkek, 13 (%62)'ü ise kadındı. Kadın hastalarda daha fazla sayıda depresyon saptandı (p< 0.05). GDÖ skorları Grup B'deki hastalarda daha yüksekti (p< 0.05). GDÖ skorları ile yaş arasında pozitif korelasyon vardı (r= 0.648, p= 0.023) ve kadın hastalar daha yüksek GDÖ skoruna sahiplerdi. (p< 0.05). Depresyon olmayan hastalarda, tedaviye uyum daha iyiydi (p< 0.05). Tüm DSKY hastalarında DSKY nedeniyle hastaneye yatış sayısı ile GDÖ skorları arasında pozitif korelasyon saptandı (r= 0.415, p< 0.05). Tüm DSKY hastalarında EF ile GDÖ skorları arasında negatif korelasyon saptandı (r= -0.307, p= 0.019). Sonuç: DSKY nedeniyle hastaneye yatırılan hastaların büyük kısmında depresyon görülebilmektedir. Bu hastalarda psikiyatrik semptomlara dikkat edilmeli ve gerektiğinde uygun tedavi başlanmalıdır.

Anahtar Kelimeler:

Depresyon; kalp yetmezliği; prognoz; mortalite.

Depression and Effect of Mortality in Hospitalized Patients with Decompensated Heart Failure

Introduction: Hearth failure frequently seems with depression and increases the morbidity and mortality with worse prognosis. In this study, we aimed to investigate the psychological situation of decompensated syctolic heart failure (DSHF) patients and applied medical and psychological therapy to them. Materials and Methods: Totally 71 patients enrolled to the study which entered to Cardiology Department of Abant Izzet Baysal University Medical School Hospital with diagnosis of functional class II-IV DSHF according to New York Cardiology Association classification and ejection fraction (EF) of 40% or lower. These patients were divided into two groups (Group A: NHYA grade 2-3, Group B NYHA grade 4). The depression of patients were evaluated by geriatric depression scale (GDS). Results: Twenty one (29.6%) of 71 patients had depression consisting of 8 (38%) male and 13 (62%) female. The depression in female patients were significantly different from male patients (p< 0.05). GDS scores were significantly higher in group B patients (p< 0.05). There was a positive corelation between GDS scores and age (r= 0.648, p= 0.023) and female patients have had significantly higher GDS scores (p< 0.05). The adaptation to the treatment was significantly better in non-depressive patients (p< 0.05). There was a positive corelation between the hospital entrance number due to NC-SHF and GDS scores in all DSHF (r= 0.415, p< 0.05). On the other hand, there was a negative corelation between the EF and GDS scores (r= -0.307, p= 0.019). Conclusion: Depression is frequently seen in patients with DSHF. These patients should be carefully followed against psychiatric symptoms to give adequate treatment.

Keywords:

Depression; heart failure; prognosis; mortality.,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi