KALAMANOĞLU Merih BALCI, Murat YALÇINSOY, Nalan ADIGÜZEL, Gökay GÜNGÖR, Cüneyt SALTÜRK, Zuhal KARAKURT, Müyesser ERTUĞRUL, YAZICIOĞLU Özlem MOÇİN, Eylem ACARTÜRK, Gülgün ÇETİNTAŞ

Göğüs hastalıkları yoğun bakım ünitesindeki akut dahili sorunların mortaliteye etkisi

Çalışmamızda göğüs hastalıkları yoğun bakım ünitesi (YBÜ)’nde karşılaşılan akut dahili sorunlar ve akut tedavi uygulamalarında mortaliteyi etkileyen risk faktörleri araştırıldı. İleriye dönük gözlemsel kohort çalışmada, 20 yataklı göğüs hastalıkları YBÜ’de, 2008 yılındaki tüm hastalar çalışmaya alındı. Hastalar; yaşayanlar grup 1, ölenler grup 2 olarak ikiye ayrıldı. Hastaların demografik özellikleri ve akut dahili sorunları (aritmi, akut böbrek-karaciğer yetmezliği, dopamin, doputamin, perlinganit infüzyonu) kayıt edildi. Mortaliteyi etkileyen faktörler için çoklu regresyon analizi uygulandı. Çalışma döneminde 603 hasta vardı; grup 1 n= 503 (%83.4), grup 2 n= 100 (%16.6). Her iki grup yaş ve cinsiyet yönünden benzerdi. Akut dahili sorunlarda mortalite için risk faktörleri odds oranı (OR), %95 güven aralığı (GA), p değeri olarak sırasıyla septik şok OR: 22.52, GA 8.11-62.57, p< 0.000; perlinganit infüzyon gereği OR: 9.28, GA: 1.61-53.37, p< 0.012; aritmi varlığı OR: 7.81, GA: 3.46-17.65, p< 0.000; akut böbrek yetmezliği OR: 2.88, GA: 1.24-6.65, p< 0.013; dopamin ihtiyacı OR: 2.83, GA: 1.06-7.65, p< 0.037 bulundu. Göğüs hastalıkları YBÜ’lerindeki solunum sorunları ön planda olan hastalarda kalp ve böbrek yetmezliği gibi ek dahili sorunlar gelişmesi, solunum yetmezliğine ilave olarak mortalite için ek risk faktörü oluşturmaktadır. YBÜ sayılarında artış bir sağlık politikası olmakla birlikte göğüs hastalıkları kaynaklı YBÜ takibi gereken hastaların dahili diğer sorunlarını da hızla tedavi edebilecek donanıma sahip koşul ve personelin hazır olması gerekmektedir.

The effect of acute internal problems for mortality in respiratory intensive care unit patients

Acute internal problems in the respiratory intensive care unit (ICU) and risk factors affecting mortality in the acute treatment applications were investigated. All patients in 20-bed intensive care unit for chest diseases enrolled to this prospective observational cohort study during 2008. Patients were classified as living in group 1 and deaths in group 2. Demographics and acute internal problems (arrhythmias, acute kidney-liver failure, dopamine, doputamin, perlinganit infusion) were recorded. Multiple regression analysis was performed for factors affecting mortality. There were 603 patients during the study period, group 1, n= 503 (83.4%), group 2, n= 100 (16.6%). Both groups were similar in terms of age and gender. Odds ratio (OR), 95% confidence interval (CI), p value for internal problems of acute risk factors for mortality were found as; septic shock OR: 22.52, CI 8.11-62.57, p< 0.000; need of perlinganit infusion OR: 9.28, CI: 1.61-53.37, p< 0.012; the presence of arrhythmia, OR: 7.81, CI: 3.46-17.65, p< 0.000; acute renal failure, OR: 2.88, CI: 1.24-6.65, p< 0.013 and the need for dopamine OR: 2.83, CI: 1.06-7.65, p< 0.037, respectively. Internal problems such as cardiac and renal dysfunction can devolop in respiratory ICU patients with pulmonary diseases and these problems constitude additional risk factors for mortalitiy. While the number of ICU is increasing with new health policies, each internal requirement and personnel equipped to treat the problem quickly must be considered.

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