İsa BAŞPINAR, Sertaç GÜLER, Burak DEMİRCİ, Mehmet YURDAKUL, Abuzer COŞKUN, Yavuz KATIRCI

Acil serviste geriatrik hastaların değerlendirilmesinde skorlama sistemlerinin rolü

Amaç: Bu çalışmada acil serviste kritik geriatrik hastaları belirlemede skorlama sistemlerinin güvenilirliğini karşılaştırmayı amaçlanmıştır. Gereç ve Yöntem: Bu prospektif çalışmaya 15 Ekim 2014-15 Kasım 2014 tarihleri arasında acil servise başvuran 65 yaş üstü hastalar dahil edildi. Çalışmada APACHE II (Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II) , REMS (Hızlı Acil Tıp Skoru), HOTEL (hipotansiyon, oksijen satürasyonu, düşük vücut sıcaklığı, EKG değişiklikleri ve bağımsız yaşam kaybı), VIEWS (Vital PAC Erken Uyarı Skoru) ve VIEWS-L (Vital PAC Laktat Seviyesi ile Erken Uyarı Skoru) değerlendirildi. Bulgular: Çalışmaya dahil edilen 244 hastadan sağ kalanların yaş ortalaması 75.69 ± 6.96 yıl, ölen vakaların yaş ortalaması 80.47 ± 6.63 yıl, 139’u (%57) kadındı. Çalışmaya alınan hastaların 30'u (%12,3) mortal sonuçlandı. Yoğun bakımda yatan hastaların risk puanları, servisten taburcu olan veya hospitalize edilenlere göre daha yüksekti. Mortalite grubundaki tüm risk skorları diğer hasta gruplarına göre anlamlı derecede yüksek bulundu. Sonuç: Çalışma, acil serviste geriatrik hastaların değerlendirilmesinde, mortaliteyi ön görebilmek ve kritik hastaları seçebilmek için risk skorlama sistemlerinin güvenle kullanılabileceğini göstermiştir.

Anahtar Kelimeler:

Risk Skorlama Sistemleri, geriatrik hasta, mortalite, acil servis

The role of scoring systems in evaluation of the geriatric patients in emergency department

Purpose: The aim of this study was to compare the reliability of scoring methods in determining critical geriatric patients in the emergency department. Materials and Methods: This prospective study included patients aged over 65 who presented to the emergency department between 15 October 2014 and 15 November 2014. APACHE II (Acute Physiology and Chronic Health Evaluation II), REMS (Rapid Emergency Medicine Score), HOTEL (Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence), VIEWS (Vital PAC Early Warning Score) and VIEWS-L (Vital PAC Early Warning Score with Lactate Level) were evaluated. Results: Of the 244 patients included in the study, the mean age of survivors was 75.69 ± 6.96 years, and the mean age of the mortal cases was 80.47 ± 6.63 years, 139 (57%) women. It was found that 30 (12.3%) of the patients included in the study died. The risk scores of the patients hospitalized in the intensive care unit were higher than those who were discharged or hospitalized. All risk scores in the mortality group were found to be significantly higher than the other patient groups. Conclusion: The study showed that risk scoring systems can be used safely in the evaluation of geriatric patients in the emergency department, to predict mortality and to select critically ill patients.

Keywords:

emergency medicine , geriatric patient, mortality, risk scoring systems,

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