Postoperatif pulmoner komplikasyonları öngörmede yaşam kalitesinin önemi

Amaç: Abdominal cerrahilerde postoperatif pulmoner komplikasyonlar (PPK), morbitide ve mortalitenin önemli bir nedenidir. Ayrıca hastanede yatış süresini uzatan önemli bir faktördür. Preoperatif değerlendirme, komplikasyonların tahmin edilmesinde ve önlem alınmasında önemli bir yer oluşturmaktadır. Değerlendirme sıklıkla öykü, fizik muayene, akciğer grafisi, solunum fonksiyon testleri, gerekli olgularda arteriyel kan gazı, ve egzersiz testleri ile yapılmaktadır. Bu çalışmada, diğer değerlendirme parametrelerinden farklı olarak PPK’ı öngörmede yaşam kalitesinin önemini araştırmayı amaçladık. Yöntem: Çalışmamıza Genel Cerrahi AD’da elektif batın cerrahisi yapılacak olan 124 hasta alınmıştır. Hastalar ameliyat öncesi 1 haftalık dönemde değerlendirilmiş ve nottingham sağlık profili (NSP) skoru hesaplanmıştır. Postoperatif 48.saat sonrasında semptomlar ve komplikasyonlar incelenerek, preoperatif NSP değerleri ile karşılaştırılmıştır. Bulgular PPK görülen hastalarda NSP-total puanı ort. 125,71  114,09 puan ve görülmeyenlerde ort. 63,65  72,75 puandı (p=0.002). Fiziksel mobilite, ağrı, enerji düzeyi, duygusal reaksiyon, uyku durumu, ve sosyal izolasyon düzeylerine göre yapılan değerlendirmede emosyonel durum haricinde diğer tüm puanlar komplikasyon görülen hastalarda daha yüksek saptandı. Mortalite görülen hastaların ort. 209,31  130,74 puan olduğu görüldü. Hastalar NSP puanlarına göre grup-1 (0-49,9), grup-2 (50,0-99,9), grup-3 (100-149,9) ve grup-4 (>150 puan) olarak sınıflandırıldı. Buna göre grup-4 olan hastalarda %72,7 pulmoner komplikasyon görüldü (p

The role of health quality in predicting postoperative pulmonary complications

Aim: Postoperative pulmonary complications (PPC) in abdominal surgeons is an important factor that prolongs the hospitalization period as well as is an important cause of morbidity and mortality. Preoperative evaluation is an important part of estimating complications and taking precautions. However, pulmonary function tests, arterial blood gases, and exercise tests are used in the evaluation. In this study, we aimed to investigate the importance of quality of life in predicting PPC different from other evaluation parameters. Patients and Methods: 124 patients who were assigned for various elective abdominal procedures in department of surgery; were included in the study. Notthingham health profile (NHP) scores 1 week prior to the surgery were calculated for each patient and were compared to the pulmonary complications (PPC) that evolved in the postoperative 48th hour. Results: In patients with PPC mean NHP score was 125,71 + 114,09 and in patients without PPC the score was found to be 63,5 + 72,75. The difference among the groups was statistically significant. The patients were distributed in to 4 groups according to their score and in group 4 (>150) pulmonary complication rate was 72,7% (p

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