Canan KARA GENOĞLU, Ataman KÖSE, Seyran BOZKURT BABUŞ, İbrahim TOKER, Semra ERDOĞAN, Necati MUŞLU, Ahmet ÇELİK

Acil Serviste Akut Kalp Yetmezliği Hastalarında Nefes Darlığının Üç Skala ile Değerlendirilmesi

Amaç: Bu çalışmada, acil serviste (AS) akut kalp yetmezliği (AHF) olan hastalarda üç dispne ölçeğini (Likert, VAS ve NRS) karşılaştırmayı amaçladık. Gereç ve Yöntemler: Acil serviste AHF tanısı konan hastalarda prospektif olarak yapılan bu çalışmaya toplam 114 hasta dahil edildi. Başvuru sırasında ve 4. saatte dispne skalaları dispne şiddeti açısından değerlendi. Likert, Visual Analog Skala (VAS) ve Sayısal Derecelendirme Ölçeği (SDÖ) kullandı. Bulgular: Çalışmaya katılan hastaların altmış beşi kadındı. Hastaların ortalama yaşı 72.1 ± 11.7 yıl idi. Nefes darlığı düzelen hastaların %74,1'i taburcu edildi. Hastaların 77'si acil servisten taburcu edilirken 37'si hastaneye yatırıldı ve yatan hastaların %51,7'sinde nefes darlığında düzelme olmadı. Her skalada tedaviden sonra dispne şiddeti azaldı (p<0.05). Dördüncü saat skorları her üç ölçek için düşüktü (p<0.01), ancak hastanede yatan hastalarda 4. saat VAS ve NRS skorları taburcu olana göre daha yüksekti (p<0.01). Dispne skalalarının başvuru ve 4. saatinde de benzer anlamlı doğrusal ilişki bulundu (p<0.001). Sonuç: Acil serviste AKY olan hastalarda dispne skalaları nefes darlığında düzelme ve klinik rahatlama ile uyumludur, buna karşın nefes darlığındaki düzelme hastaların hastaneye yatırılması mı yoksa taburcu edilmesi mi gerektiğine karar vermek için yetersizdir.

Anahtar Kelimeler:

Acil servis, kalp yetmezliği, nefes darlığı, dispne skalaları

Assessment of Dyspnea in Acute Heart Failure Patients with Three Scales in the Emergency Department

Aim: This study aimed to compare the three dyspnea scales (Likert, VAS, and NRS) in patients with acute heart failure (AHF) in the emergency department (ED). Materials and Methods: This study enrolled 114 patients prospectively diagnosed with AHF in the ED. We assessed the dyspnea scales for severity at admission and the 4th hour. We used the Likert scale, Visual Analogue Scale (VAS), and the Numerical Rating Scale (NRS). Results: Sixty-five patients were women. The mean age of the patients was 72.1 ± 11.7 years. 74.1% of the patients whose dyspnea was relieved were discharged. Seventy-seven of the patients were discharged from ED, while 37 were hospitalized, and 51.7% of the hospitalized patients had no improvement in dyspnea. The severity of dyspnea decreased after the treatment on each scale (p< 0.05). The 4th-hour scores were lower for all three scales (p< 0.01), but VAS and NRS scores on the 4th hour were higher in hospitalized patients than in discharged (p< 0.01). There was a similarly significant relationship between the admission and 4th hour of dyspnea scales (p<0.001). Conclusion: Dyspnea scales are compatible with dyspnea and clinical relief in patients with AHF in the ED, whereas improvement in dyspnea is insufficient to decide whether the patient should be hospitalized or discharged.

Keywords:

Emergency department, heart failure, shortness of breath, dyspnea scales,

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