Mehmet UYAR, Semra KARAMAN, Tuncer ŞİMŞEK, Can EYİGÖR, Ali Reşat MORAL

Retrospective review of critically ill obstetrical patients: a decade’s experience

Amaç: Bu çalışmanın amaçları, obstetrik hastaların yoğun bakım ünitesine (YBÜ) kabul nedenlerini ve klinik sonuçlarını araştırmak, son yıllarda yaygın olarak kullanılan skorlama sistemlerinin bu hastalarda mortalite tahminindeki rollerini karşılaştırmak ve kötü prognostik faktörleri belirlemektir. Yöntem ve gereç: Veriler Ocak 1999 ile Nisan 2009 tarihleri arasında kurumumuzda yoğun bakıma yatırılan obstetrik hastalardan retrospektif olarak elde edildi. Demografik karakteristikler, Akut Fizyoloji ve Kronik Sağlık Değerlendirme II (APACHE II) skorlaması, Sekansiyel Organ Yetmezliği Skorlaması (SOFA) ve Glasgow Koma Skorlaması (GKS) değerleri kayıt altına alındı. Hastalar karşılaştırma için: Grup 1, YBÜ’nde ölen hastalar, Grup 2, YBÜ’nden taburcu olan hastalar olarak 2 gruba ayrıldı. Bulgular: Yoğun bakıma en sık kabul nedeni olarak preeklampsi/eklampsi/HELLP (% 65,1) tanıları gözlendi. APACHE II, SOFA ve GKS değerleri karşılaştırıldığında Grup 1 hastaların sonuçları Grup 2 hastalara oranla istatistiksel olarak anlamlı olarak daha kötüydü (P < 0,05). Sonuç: Skorlama sistemleri obstetrik hastalarda mortalite olasılığını belirleme açısından yararlıdır. Bu skorlama sistemlerinin kullanımıyla; yoğun bakımlara düşük riskli hastaların gereksiz kabulü veya kritik hastalarda gecikmiş YBÜ bakımı önlenebilir.

Kritik obstetrik hastaların retrospektif değerlendirilmesi: On yıllık deneyim

Aim: To investigate the reasons for the admission of obstetrical patients to the intensive care unit (ICU) and their clinical outcomes, to compare the roles of the current scoring systems in estimating the mortality of these patients, and to determine adverse prognostic factors in critically ill obstetrical patients. Materials and methods: Data were retrospectively obtained from obstetrical patients admitted to the ICU in our institution between January 1999 and April 2009. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and Glasgow Coma Scale (GCS) score of patients at the time of their first ICU admission were recorded. Patients were divided into 2 groups for comparison: Group 1, patients who died in the ICU, and Group 2, patients who were discharged from the ICU. Results: Preeclampsia, eclampsia, and the hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP) were the most common diagnoses requiring ICU admission (65.1%). APACHE II, SOFA, and GCS values were signifi cantly worse in Group 1 patients compared with Group 2 patients (P < 0.05). Conclusion: Scoring systems help to determine the probability of mortality in obstetrical patients. Utilizing these scoring systems may prevent both the unnecessary admission of low-risk patients and delayed ICU care for critically ill patients.

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