Müge TÜRKER, Ekim SAĞLAM GÜRMEN, Adnan BİLGE, Cumhur Murat TULAY

DİSPNE İLE GELEN HASTALARDA KLİNİK BULGULAR VE KAN GAZI PARAMETRELERİ

Amaç Acil servise dispne şikayet ile başvuran hastalarda, OCS-9 skoru kullanılarak klinik durumu belirlemek. Gereç ve Yöntem Bu çalışma, solunum sıkıntısı olan 373 hasta retrospektif olarak incelenerek gerçekleştirildi. Dispne ile başvuran hastalarda, 3 önemli kan gazı parametresi kulanılarak (pH, baz açığı, laktat seviyesi) OCS-9 değeri hesaplandı. Klinik ve kan gazı parametreleri (OCS-9 skorları), hastaların son durumları ( taburcu, servis yatış, yoğun bakım yatış, ölüm) ile karşılaştırıldı. Bulgular Hasta klinik sonuçlandırmalarının istatistiksel karşılaştırmasında, OCS-9 skoru anlamlı olarak bulundu. Servis yatışı olan veya taburcu edilen hastaların OCS-9 skoru, yoğun bakım yatışı yapılan hastalara göre daha yüksekti. OCS-9 skorunun cut-off değeri 1 kabul edildiğinde, yoğun bakım yatış ve ölüm öngörme duyarlılığı %46.9 ve özgüllüğü %77.08 olarak bulundu. Sonuç OCS-9 skorunun, acil servise dispne ile başvuran hastalarda klinik sonuçları ve kısa süreli prognozu öngörmede bir yöntem olarak kullanılabileceğini düşünüyoruz.

CLINICAL FINDINGS AND BLOOD GAS PARAMETERS IN PATIENTS PRESENTED WITH DYSPNEA

ObjectiveTo determine the effectiveness of Objective Classification Scale (OCS-9 scores) at the emergency department on the patients presenting with complaintsof dyspnea.Materials and MethodsThe study was performed retrospectively on 373 patients with respiratory distress. Three important parameters of blood gas (pH, base deficit, lactate level)were used to calculate the OCS-9 value of patientswho were admitted with dyspnea. Clinical parametersand blood gas parameters (OCS-9 scores) were compared with the outcome status of the patients (discharge, service stay, intensive care stay, exitus).ResultsIn the differentiation of the clinical outcomes of thepatients, the effectiveness of the OCS-9 value wasfound to be significant. OCS-9 scores of the patientswho were hospitalized at a regular ward or who were discharged were higher than those who were hospitalized at the intensive care unit (ICU). When cut-off value for OCS-9 score was accepted as 1, its sensitivityfor predicting exitus and hospitalization at an ICU was46.9% and specificity was 77.08%.ConclusionWe suggest that the OCS-9 score may be used asa method to help predict clinical outcomes and shortterm prognosis in patients presenting to the emergency room with dyspnea.

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