Mehmet ÜSTÜN, Gizem KILINÇ, Avni Can KARACA, Halit Batuhan DEMİR, Nimet ŞENOĞLU, Cengiz AYDIN

Genel Cerrahi Yoğun Bakımda Postoperatif Dönemde Uzamış Yatış Süresine Etki Eden Faktörler

Amaç:Yoğun bakımda uzamış yatış süresi, yüksek mortalite riski ile ilişikilidir. Bunu öngörmek, mortaliteyi azaltmak amacıyla önemlidir. İkinci basamak genel cerrahi yoğun bakımda uzamış yatış süresine etki eden faktörleri saptamayı amaçladık. Gereç ve Yöntem:Ocak 2014 - Ekim 2017 tarihleri arasında, genel cerrahi prosedür sonrası postoperatif dönemde genel cerrahi yoğun bakım takibine alınan hastalardan uzamış yatış süresine sahip 68 hasta ve bu hastalar ile benzer özellikte randomize olarak seçilmiş aynı sayıdaki hastalar iki grup şeklinde karşılaştırmalı olarak incelendi Bulgular:Uzamış yatış süresi olan hastaların median yaşı 69,00(22,50) iken kontrol grubundaki hastaların median yaşı 59,00(14,75) idir (p < 0,001). Uzamış yatış süresi grubundaki hastalardan 59 tanesine abdominal acil cerrahi prosedür, 9 tanesine abdominal elektif cerrahi prosedür, uygulandı. Kontrol grubundaki hastalardan abdominal acil prosedür uygulanan hasta sayısı 23, abdominal elektif prosedür uygulanan hasta sayısı 45 idi ( p=0,001). Uzamış yatış süresi grubundaki hastalardan 48’inde mortalite gelişirken, diğer gruptaki hastaladan 7’sinde mortalite gelişmiştir (p=0,001). Yapılan multivariate analizleri sonucunda; uzamış yatış grubunda acil abdominal cerrahi prosedür uygulaması (p<0,001) (Odds ratio:12.983), yaş ( p= 0.006) (Odds ratio:0.96) , mortalite oranı (p<0,001) (Odds ratio:20,91) istatistiksel olarak anlamlı yüksek bulunmuştur.Sonuç: Acil abdominal cerrahi prosedür uygulaması, yaş ve yüksek mortalite oranı, uzamış yatış süresi ile ilişkilendirilmiştir.

Anahtar Kelimeler:

uzamış yatış, yoğun bakım, genel cerrahi

Factors Affecting Prolonged Stay in Postoperative Period in General Surgery Intensive Care Unit

Aim:Prolonged stay in intensive care unit is associated with a high risk of mortality. Predictability of it is important to reduce mortality. The aim of this study is to determine the factors affecting prolonged stay in secondary general surgery intensive care unit.Materials and Methods: Between January 2014 and October 2017, 68 patients with prolonged stay undergoing general surgery ICU follow-up in the postoperative period after the general surgical procedure and the same number of randomly selected patients with similar characteristics were compared in two groupsResults:The median age of the patients with prolonged stay was 69,00 (22,50) and the median age of the patients in the control group was 59,00 (14,75) (p < 0,001).In prolonged stay group, 59 patients underwent abdominal emergency surgery, and 9 patients underwent abdominal elective surgery. The number of patients undergoing abdominal emergency procedures in the control group was 23, and the number of patients undergoing abdominal elective procedure was 45 ( p=0,001). Fourty eight of the patients in the prolonged stay group had mortality, 7 of the patients in the control group had mortality (p=0,001). As a result of multivariate analysis; in the prolonged stay group, emergency abdominal surgical procedure rate (p <0.001) (Odds ratio:12.983), age (p = 0.006) (Odds ratio:0.96) and mortality rate (p <0.001) (Odds ratio: 20,91) was found to be statistically significant.Conclusion: . Emergency abdominal surgical procedure, age and high mortality rate are associated with prolonged stay.

Keywords:

prolonged stay, intensive care unit, general surgery,

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