Mehmet OZEL, Emine GAFFARİ, Hakan TOPACOGLU, Özgür KARCIOĞLU

Yaşlı Acil Servis Hastaları Sonuçlarının Tahmininde Ulusal Erken Uyarı Skoru ve Perfüzyon İndeksinin Kullanımı

Amaç: Vital değerler, bir hastanın durumunu değerlendirmek için en önemli parametrelerdir ve National Early Warning Score, hastanın durumunun ne kadar acil olduğunu tahmin etmek için vital parametrelerle değerlendirilmesine yardımcı olur. Perfüzyon indeksi, bir hastanın periferik dokusundaki pulsatil kan akışının pulsatil olmayan/statik kan akışına oranıdır. Bu çalışmada National Early Warning Score ile perfüzyon indeksi arasındaki ilişkiyi ve acil servise başvuran yaşlı hastaların sonlanımlarını tahmin etmede National Early Warning Score ve perfüzyon indeksinin yararlı olup olmadığını değerlendirmeyi amaçladık. Yöntemler: Bu prospektif kesitsel çalışmada, acil servise travma dışı nedenlerle başvuran yaşlı hastaları değerlendirdik. National Early Warning Score, perfüzyon indeksi ve hastaların acil servis sonlanımları kaydedildi. Sonuçlar: Toplam 967 hasta (%55 kadın, ortalama yaş=74.8) kaydedildi. Hastaların başvuru anındaki National Early Warning Score ile perfüzyon indeksi arasında anlamlı, negatif bir korelasyon vardı (p < 0.001). Hastaneye yatırılan hastalar taburcu edilenlere göre daha yüksek National Early Warning Score ve daha düşük perfüzyon indeksi değerlerine sahipti (her ikisi içinde p < 0.001). Yoğun bakım ünitesine yatırılan hastalarda, servise yatırılanlara göre önemli ölçüde daha yüksek National Early Warning Score ve daha düşük perfüzyon indeksi değerleri vardı (her ikisi içinde p < 0.001). Tartışma: National Early Warning Score ve perfüzyon indeksi, acil serviste kritik durumdaki yaşlı hastaları ayırt etmek için kullanılabilecek faydalı araçlardır.

Anahtar Kelimeler:

Acil Servis, erken uyarı skoru, perfüzyon indeksi, geriatri

Use of National Early Warning Score and Perfusion Index in Predicting Outcomes of Elderly Emergency Department Patients

Objectives: Vitals are the most important parameters for assessing a patient’s status and the National Early Warning Score helps to assess vitals to predict how urgent a patient’s condition is. The perfusion index is the ratio of the pulsatile blood flow to the non-pulsatile/static blood flow in a patient’s peripheral tissue. We aimed to investigate the relationship between the National Early Warning Score and perfusion index in the courses and evaluate whether NEWS and PI are useful in predicting outcomes of older patients in an Emergency Department. Method: In this prospective cross-sectional study, we evaluated non-traumatized older patients admitted to an Emergency Department. National Early Warning Score, perfusion index, and patients’ Emergency Department outcomes were recorded. Results: A total of 967 patients (55% female, mean age=74.8) were enrolled. The initial National Early Warning Score of the patients had a significant, negative correlation with perfusion index (p < 0.001). Patients admitted to the hospital had higher National Early Warning Score and lower perfusion index values than those discharged (both p < 0.001). Patients admitted to an ICU had significantly higher National Early Warning Score and lower perfusion index values than those admitted to the medical floor (both p < 0.001). Conclusion: The National Early Warning Score and the perfusion index are useful instruments to distinguish critically ill older patients in an Emergency Department.

Keywords:

Emergency department, Early Warning Score, Perfusion index, Elderly.,

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