Esra YAKIŞIK ÇAKIR, Çiğdem YÜCEL, Murat KIZILGÜN, Işıl ÖZKOÇAK TURAN

Kalsiyum, D vitamini ve paratiroid hormon düzeylerinin kritik hastaların prognozuna etkisi

Amaç: Sepsisli hastalarda elektrolit ve hormonlardaki değişimi değerlendiren yeterli çalışma yoktur. Çalışmamızın amacı serum kalsiyum (Ca), magnezyum (Mg), fosfor (P), 25-hidroksivitamin D (25(OH)D) ve paratiroid hormon (PTH) düzeylerindeki değişimler ile sepsisli hastalarda mortalite arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmamız Ekim 2017-Ocak 2019 tarihleri arasında yoğun bakım ünitesinde (YBÜ) yatan sepsisli hastalar üzerinde yapılmıştır. Kalsiyum, Mg, P, 25(OH)D ve PTH düzeyleri, demografik ve klinik özellikleri ile birlikte hayatta kalan ve ölen hastalar karşılaştırıldı. Bulgular: Çalışmaya toplam 225 hasta alındı. 225 hastanın 94'ü (%41,2) öldü ve 131'i (%58,8) taburcu edildi. Ölen hastalarda hayatta kalan hastalardan, PTH ve P seviyeleri anlamlı derecede daha yüksek, 25(OH)D, Ca ve Mg seviyeleri ise anlamlı derecede daha düşük bulundu. Sonuç: Sepsis sırasında hassas bir denge içinde olan Ca metabolizmasının hipokalsemi, hipomagnezemi, hiperfosfatemi, düşük 25(OH)D ve yüksek PTH yönünde değişmesi mortalite ile ilişkilendirildi.

The influence of calcium, vitamin D and parathyroid hormone levels on the prognosis of critical patients

Purpose: There are not enough studies evaluating the change in electrolytes and hormones in patients with sepsis. The aim of our study is to evaluate the relationship between the changes in serum calcium (Ca), magnesium (Mg), phosphorus (P), 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) levels and mortality in patients with sepsis. Materials and Methods: Our study was conducted on patients with sepsis who were hospitalized in the intensive care unit (ICU) between October 2017 and January 2019. The levels of Ca, Mg, P, 25(OH)D and PTH, together with demographic and clinical characteristics of non-survivor and survivor patients, were compared. Results: A total of 225 patients were enrolled into the study. Of the 225 patients, 94 patients (41.2%) died and 131 patients (58.8%) were discharged. PTH and P levels were found to be significantly higher, and 25(OH)D, Ca, and Mg levels were significantly lower in non-survivor patients than in survivor patients. Conclusions: During sepsis, the change in Ca metabolism which is in a delicate balance, in the direction of hypocalcemia, hypomagnesemia, hyperphosphatemia, low 25(OH)D and high PTH were found to be associated with mortality.

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