Veysel HAKSÖYLER, Ömer KAYA, Tolga KÖŞECİ, Emre KARAKOÇ, İsmail Fikri BAŞLAMIŞLI

Dahiliye yoğun bakım ünitesinde trombositopeni ve mortalite ve morbidite ilişkisi

Amaç: Bu çalışmada bir Üniversite Dahiliye Yoğun Bakım Ünitesinde (DYBÜ) trombositopeni sıklığı, nedenleri, klinik sonuçları ile mortalite ve morbiditeye olan katkısını saptamayı amaçladık.Gereç ve Yöntemler: Temmuz 2011-Ağustos 2012 tarihleri arasında yoğun bakımda takip edilen vetrombosit sayısı 150.000/uL’nin altında olan 165 hasta çalışmaya dahil edildi. Trombositopeni nedenleri araştırıldı. Trombositopenisi olan ve trombositopenisi olmayan hastaların mortalite ve yoğun bakım yatış sürelerikarşılaştırıldı.Bulgular: Çalışma döneminde DYBÜ’de hastaların %30,1’inde trombositopeni gelişti (165/548). Hastaların 30 (%18)’unda trombositopeni nedeni sepsis, 18 (%10,9)’inde dissemine intravasküler koagülasyon (DİK) idi. Çalışma süresince 165 trombositopenik hastanın 115’i (%69,7), trombositopenik olmayan 383 hastanın 173’ü (%45,1) kaybedildi. Trombositopenisi olan hastalarda mortalite daha fazlaydı. Hastalarda trombosit düzeyi düştükçe mortalitenin istatistiksel olarak anlamlı düzeyde arttığı gözlendi. Aynı APACHE II skoruna sahip hasta gruplarında trombosit sayısı düştükçe mortalitenin istatistiksel olarak anlamlı olarak arttığı saptandı.Sonuç: Trombositopeninin en sık sebepleri sepsis ve DİK olup trombositopeni yoğun bakımda mortaliteyi arttıran bir etkendir.

Anahtar Kelimeler:

yoğun bakım, trombositopeni, APACHE II, mortalite, sepsis

Relationship between thrombocytopenia and mortality and morbidity in the internal medicine intensive care unit

Purpose: In this study, we aimed to determine the incidance, causes, clinical outcomes and the effect on mortality and morbidity of thrombocytopenia in an University internal medicine intensive care unit (IMICU).Material and Methods: Between July 2011 and August 2012, 165 patients who were followed up in intensive care unit and whose platelet count was below 150,000 / uL were included in the study. The causes of thrombocytopenia were investigated. Patients with and without thrombocytopenia were compared in terms of mortality and duration of stay in intensive care unit.Results: During the study period, thrombocytopenia was developed in %30.1 of patients in IMICU (165/548). Causes of thrombocytopenia in 30 (%18) patients was sepsis and in 18 (%10,9) was disseminated intravascular coagulation (DIC). During the study, 115 (%69.7) of 165 thrombocytopenic patients and 173 (%45.1) of 383 non-thrombocytopenic patients died. Mortality in the patients with thrombocytopenia was higher. There was a statistically significant increase in mortality as the platelet count drops. Statistically significant increase in mortality were detected as the platelet count decreased in patients with the same APACHE II score.Conclusion: The most common causes of thrombocytopenia are sepsis and DIC, and thrombocytopenia is an effect that increases the mortality in the intensive care unit.

Keywords:

intensive care, thrombocytopenia, APACHE II, mortality, sepsis,

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