Gökhan SERTÇAKACILAR, Güneş Özlem YILDIZ, İpek BOSTANCI, Zafer CUKUROVA

Predictors of mortality and complications in patients treated in intensive care following non-cardiac emergency surgery

Amaç: Artan nüfus ve yaşam süresi nedeniyle acil cerrahi geçiren hastaların sayısının artması beklenmektedir. Bununla birlikte acil cerrahi gerektiren farklı cerrahi tanılar farklı komplikasyonlara ve morbiditeye neden olmaktadır. Bu araştırma, hastane içi mortalite ve morbidite öngörücüleri de dahil olmak üzere, acil cerrahi uygulanan hastalardaki sonuçları incelemektedir.Materyal ve Metot: 2014 ve 2019 yılları arasında üçüncü basamak bir sağlık kuruluşunda acil cerrahi geçiren ve cerrahi sonrası yoğun bakım endikasyonu konulan hastaların retrospektif bir çalışması yapıldı. Hastaların demografik verileri, komorbiditeleri, cerrahi endikasyonları ve perioperatif risk değerlendirme verileri toplandı. Sonuçlar, yoğun bakımda kalış süresi, inotrop ihtiyacı, taburculuk durumu ve hastane içi mortalite ve morbiditeyi içeriyordu. Hastane içi mortalite belirleyicilerini belirlemek için çok değişkenli lojistik regresyon kullanıldı.Bulgular: 886 hasta başvurusunun ortalama yaşı 52.3 idi. Acil cerrahi uygulanan 65 yaş ve üstü hastaların mortalite oranı (%38.1) diğer hastalara göre istatistiksel açıdan anlamlı olarak yüksekti (p < 0.001). Amerikan Anesteziyologlar Derneği (ASA) fiziksel durum sınıflandırması ortalaması 3E idi. ASA, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi (APACHE II), Basitleştirilmiş Akut Fizyoloji Skoru (SAPS) puanlamaları ve preoperatif lökosit, ve nötrofil değerleri yüksek olan hastalarda mortalite oranı daha yüksek saptandı (p <0.001).Sonuç: APACHE II ve SAPS III sınıflamaları ve lökosit, lenfosit gibi preoperatif bakılan laboratuar parametreleri dışında ASA skoru da acil cerrahi gerektiren kritik hasta popülasyonunda mortaliteyi öngörebilir, ayrıca hasta ve aile danışmanlığına rehberlik etmek için kullanılabilir.

Anahtar Kelimeler:

Emergency, Emergency, Surgery, Surgery, Critical care, Critical care

Predictors of mortality and complications in patients treated in intensive care following non-cardiac emergency surgery

Background: Due to the increasing population and life expectancy, the number of patients undergoing emergency surgery is expected to increase. However, different surgical diagnoses that require emergency surgery cause various complications and morbidity. This study examines outcomes in patients undergoing emergency surgery, including in-hospital mortality and morbidity predictors.

Keywords:

Emergency, Emergency Surgery, Surgery, Critical care, Critical care, Mortality, ASA score,

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