Patients with Cerebral Palsy Who are Admitted to a Chest Diseases Hospital may have Higher Mortality Rates
Amaç: Epilepsi, pnömoni, gastrit, özofajit, malnütrisyon, dehidrasyon, kırıklar ve pnömoni dışı akciğer hastalıkları (astım, plevral sıvı, solunum yetmezliği) serebral palsili (SP) hastaların hastaneye yatış nedenlerinin başında gelmektedir. Bu çalışmada göğüs hastalıkları hastanesine başvuran SP'li hastalarda solunum yolu hastalıkları ve mortalite oranlarının belirlenmesi amaçlandı.
Gereç ve Yöntem: Ocak 2010-Aralık 2017 tarihleri arasında Göğüs Hastalıkları Hastanesinde yatan SP'li hastalar çalışmaya dahil edilerek retrospektif olarak incelendi. Çalışmanın primer sonlanım noktası hastanede yatan hastaların solunum yolu enfeksiyonuna bağlı 30 günlük mortalitesiydi.
Bulgular: 23 hastaya ait 43 yatış değerlendirildi. Ortalama hastanede kalış süresi 15,5 (1-62) gündü. SP'li hastalarda hastaneye yatış nedenleri ağırlıklı olarak solunum yolu enfeksiyonlarıydı (pnömoni %88,4, akciğer apsesi %7). En sık izole edilen patojen mikroorganizma gram-negatif bakterilerdi. Hırıltılı solunum, bakteri kültüründe üreme varlığı, vazopressör ihtiyacı ve invaziv mekanik ventilasyon 30 günlük mortaliteyi artıran faktörlerdi (sırasıyla p=0,016; p=0,024; p=0,003; p=0,003). 30 günlük mortalite oranı %21,7 idi. 2 hasta ilk yatışta öldü, 4 hasta tekrarlayan yatışlarda öldü.
Sonuç: SP'li hastalar sıklıkla solunum yolu enfeksiyonları nedeniyle hastaneye yatırılmaktadır. Tekrarlayan hastaneye yatışlar mortaliteyi artırabilir. Bu çalışma, solunum yolu enfeksiyonu nedeniyle hastaneye yatan SP'li hastalardaki yüksek mortalite oranı göz önüne alındığında, bu hastaların yakın takibinin önemini vurgulamaktadır.
Patients with Cerebral Palsy Who are Admitted to a Chest Diseases Hospital may have Higher Mortality Rates Serebral Palsili Hastaların Göğüs Hastalıkları Hastanesine Yatışları Mortal Seyredebilir
Objective: Epilepsy, pneumonia, gastritis, esophagitis, malnutrition, dehydration, fractures, and non-pneumonic lung disorders (asthma, pleural fluid, respiratory failure) are the leading causes of hospitalization among cerebral palsy (CP) patients. This study aimed to determine respiratory tract diseases and mortality rates in patients with CP admitted to the chest diseases hospital.
Materials and Methods: Patients diagnosed with CP and hospitalized in Chest Diseases Hospital between January 2010 and December 2017 were included in the study and analyzed retrospectively. As the endpoint, hospitalized patients' respiratory tract infection-related 30-days mortality were examined.
Results: Forty-three hospitalizations of 23 patients were evaluated. The mean length of hospital stay was 15.5 (1-62) days. The reasons for hospitalization in patients with CP were mainly composed of respiratory tract infections (pneumonia %88,4, lung abscess %7). The most frequently isolated pathogenic microorganisms were gram-negative bacteria. Wheezing, bacterial culture growth, vasopressor and invasive mechanical ventilation were all factors that increased 30-day mortality (respectively p=0,016; p=0,024; p=0,003; p=0,003). The 30-day mortality rate was %21,7. While 2 patients died at first hospitalization, 4 patients died on recurrent hospitalizations.
Conclusion: Patients with CP are often hospitalized due to respiratory tract infections. Recurrent hospitalizations may increase mortality. This study emphasizes the importance of close follow-up with these patients considering the high mortality rate among CP patients hospitalized for respiratory tract infections.
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