İsmet TOPÇU, Melek SAKARYA, Burcu ÇETİNKAYA, Taner TAŞYÜZ, N. Zeynep EKİCİ

Yoğun bakım tedavisi gerektiren zehirlenme olgularının retrospektif olarak değerlendirilmesi

Bu çalışmada, yoğun bakım tedavisi gerektiren zehirlenme olgularının analiz edilmesi ve objektif bir klinik skorlama sistemi olan APACHE II (Akut Fizyoloji ve Kronik Sağlık Değerlendirme) skoru kullanılarak kliniğinin ciddiyeti ve prognozun değerlendirilmesi amaçlanmıştır. 1999-2003 yılları arasında akut zehirlenme tanısıyla yoğun bakım ünitesine yatırılan 165 hasta retrospektif olarak demografik veri, zehirlenme yolu, amaç, alınan maddeler, klinik analiz ve prognoz tahmini yönünden değerlendirilmiştir. Olguların yaş ortalaması 28.8'dir. %39.4'ü erkek, %60.6'sı kadındır. Mesleklere göre dağılımda en sık %29.1 ile ev hanımı ve öğrenci, %12.1 işsiz, %8.5 serbest meslek, %6.1 asker, %3.6 çiftçi, ve %13.9 diğerleri olarak saptandı. Zehirlenme yolu %88.5 oranında ağız; %10.3 solunum yoluyla idi. Zehirlenmelerin %69.1 intihar amaçlı, %27.9 kaza ve %3 doz aşımı şeklindeydi. Olguların % 97.6'sı şifa ile taburcu edildi. %2.4 oranında ise ölümle sonuçlandı. APACHE II skoru ile yoğun bakım yatış süresi ve mortalite arasında korelasyon saptandı (p

Anahtar Kelimeler:

Zehirlenme, APACHE, Geriyedönük çalışma, Yoğun bakım

Retrospective clinical evaluation of intoxication cases requiring critical care treatment

The purpose of this study was to analyze the intoxication cases requiring critical care treatment and to evaluate the prognosis using an objective clinical scoring system: APACHE II "Acute Physiology and Chronic Health Evaluation Scoring System". Between 1999 and 2003, 165 ICU patients, were evaluated retrospectively according to demographic data, route of intoxication, intoxicating material and the reason for intoxication, in order to estimate the prognosis and clinical course. The mean age of patients was 28.8. Of the poisoning cases, 39.4% were male and 60.6% were female patients. According to the distribution of occupations, the incidence was obtained as 29.1% housewife and student, 12.1% unemployed, 8.5% self-employed, 6.1% soldiers, 3.6% farmer and 13.9% the others. Intoxications were 88.5% oral and 10.3% by inhalation. 69.1% of the causes for intoxication were suicidal intent, 27.9% accidental and 3% overdose. 97.6% of the cases recovered and were discharged, while 2.4% died. There is a correlation between the length of stay in the ICU and mortality with the APACHE II score (p<0.05). As a result, APACHE II scores may be used to evaluate the severity of the case in order to estimate the prognosis in acute intoxication cases requiring critical care treatment.

Keywords:

Poisoning, APACHE, Retrospective Studies, Intensive Care,

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