Sibel DORUK, Serpil BULAÇ, Can SEVİNÇ, Alp Hakan BODUR, Ayşe YILMAZ, Serpil ÖCAL, Ünal ERKORKMAZ

Yoğun bakımda izlenen toplum kökenli pnömoni olgularının hastalık ağırlık skorlamaları ve mortalite üzerine etkili faktörler

İki farklı üniversite hastanesinde toplum kökenli pnömoni tanısıyla yoğun bakımda izlenmiş, yaş ortalaması 67.8 olan 29’u erkek, 19’u kadın toplam 48 olgu değerlendirildi. Kırk altı olgunun Glasgow Koma Skoru (GKS), “Acute Physiology Assessment and Chronic Health Evaluation II (APACHE II)”, “Pneumonia Severity Index (PSI)” ve “Sequential Organ Failure Assessment Score (SOFA)” belirlendi. En sık ek hastalık olarak serebrovasküler hastalık belirlendi. Otuz olguda mikrobiyolojik çalışma yapıldığı ve 7 olguda etkenin belirlendiği saptandı. Ortalama hastanede yatış süresi 16.1 gün, yoğun bakımda yatış süresi ise 8.8 gün idi. Ortalama GKS 11.4, PSI 130.7 olup, 38 olgu yüksek risk grubunda idi. APACHE ortalaması 20.7, SOFA ortalaması 4.4 idi. Hipotansiyon varlığı ve entübasyonun ölüm riskini artırdığı ve ölen olgularda kan üre nitrojeni, % polimorfonükleer lökosit ve solunum sayısının daha yüksek olduğu saptandı. Grup 3b ve grup 4’te sırası ile ölüm oranı %41.2 ve %44.0 idi. Toplam 20 (%41.7) olgu eksitus ile sonuçlandı.

Severity scores and factors related with mortality in cases with community-acquired pneumonia patients in intensive care unit

Totally 48 cases with diagnosed as community-acquired pneumonia who were treated in intensive care units of two different university hospital included to the study. The mean age of cases was 67.8, 29 were males and 19 females. Glasgow Coma Score (GCS), Acute Physiology Assesment and Chronic Health Evaluation II (APACHE II), Pneumonia Severity Index (PSI) and Sequential Organ Failure Assessment Score (SOFA) of 46 cases were determined. The most common comorbid disease was cerebrovascular disease. We determined that microbiological tests were made in 30 cases and pathogen agent was established in 7 cases of them. The mean lenght of stay in hospital and intensive care unit were 16.1 days and 8.8 days respectively. The mean GCS was 11.4, the mean PSI was 130.7 and 38 cases were in high risk classes. The mean APACHE II and SOFA scores were 20.7 and 4.4 respectively. We determined that hypotension and intubation increased the mortality risk. The mean blood urea nitrogen, %PNL and respiratory rate were higher in cases who were died. The mortality rate in group 3b and group 4 were respectively 41.2% and 44.0%. Totally 20 (41.7%) cases died.

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