Nöroloji Yoğun Bakım Ünitesindeki Hastalarda Perkütan Endoskopik Gastrostomi Sonrası Sağkalım

Amaç: Koronavirüs hastalığı-2019 (COVID-19) pandemisi sırasında nöroloji yoğun bakım ünitesinde yatan has-talarda Perkütan endoskopik gastrostomi (PEG) sonrası mortalite ve sağkalımı etkileyen faktörleri belirlemeyi amaçladık. Materyal ve Metod: Türkiye'de Bursa Şehir Hastanesi Nöroloji Yoğun Bakım Ünitesinde Şubat 2020 ile Mayıs 2021 tarihleri arasında yatışı sırasında PEG tüpü takılan 18 yaş ve üzeri 29 hastanın klinik ve demografik verileri geriye dönük olarak incelendi. Hastaların demografik özellikleri, klinik özellikleri ve sağkalım durumları kaydedildi. Bulgular: Çalışmamıza 29 hasta (16 kadın ve 13 erkek) dahil edildi. Ortanca yaş hayatta kalanlar arasında 71 (33-89) ve ölenler arasında 75,5 (48-90) idi. Gruplar yaş (p = 0.119) ve cinsiyet (p = 0.806) açısından benzerdi. PEG yerleştirilmesinden sonra ölüm oranı %66 idi. PEG tüpünün yerleştirilmesinden sonra ortalama genel sağkalım 129.49 gündü (%95 GA: 91.21–167.78). Cox regresyonu, birden fazla komorbiditeye sahip olmanın mortalite olasılığını 2.822 kat arttırdığını ortaya koydu (%95 GA: 1.001-7.968, p = 0.049). Sonuç: Bu bulgular, COVID-19 pandemisi sırasında Nöroloji Yoğun Bakım Ünitesi’ne kabul edilen ve PEG tüpü takılan olgularda mortalite ile ilişkili en önemli faktörün birden fazla komorbiditeye sahip olması olduğunu gös-termektedir. Çoklu komorbiditeler daha kısa sağ kalıma neden olduğundan, bu hastalarda PEG tüpü yerleştirme kararının son derece dikkatli verilmesi gerektiği görülmektedir. Ancak COVID-19'un PEG sonrası ölüm oranları ve sağkalım süresi üzerindeki etkisini netleştirmek için daha kapsamlı çalışmalar yapılmalıdır.

Anahtar Kelimeler:

perkütan endoskopik gastrostomi, COVID-19 pandemisi, komorbidite, mortalite, sağkalım

Survival Following Percutaneous Endoscopic Gastrostomy in Neurology Intensive Care Unit Patients

Background: We aimed to determine factors affecting mortality and survival after Percutaneous endoscopic gastrostomy (PEG) in patients who were hospitalized in the neurology intensive care unit during the coronavirus disease-2019 (COVID-19) pandemic Materials and Methods: The clinical and demographic data of 29 patients aged 18 years and older who received PEG tube insertion during hospitalization in the Neurology Intensive Care Unit of XXX Hospital, Turkey, between February 2020 and May 2021 were examined retrospectively. Patients’ demographics, clinical characteristics, and survival status were recorded. Results: We included 29 patients (16 females and 13 males) into our study. Median age was 71 (33–89) years among survivors and 75.5 (48–90) years among those who died. The groups were similar with respect to age (p = 0.119) and sex (p = 0.806). Mortality rate after PEG insertion was 66%. Mean overall survival after PEG tube insertion was 129.49 days (95% CI: 91.21–167.78). Cox regression revealed that having multiple comorbidities increased the likelihood of mortality by 2.822-fold (95% CI: 1.001–7.968, p = 0.049). Conclusions: These findings show that having multiple comorbidities was the most important factor associated with mortality among PEG recipients who were admitted to the Neurology Intensive Care Unit during the COVID-19 pandemic. Since multiple comorbidities cause shorter survival, it appears that the decision to insert PEG tubes must be made extremely cautiously among these patients. However, more comprehensive studies should be conducted to clarify the effect of COVID-19 on mortality rates and survival time after PEG.

Keywords:

percutaneous endoscopic gastrostomy, COVID-19 pandemic, comorbidity, mortality, survival,

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