Yoğun bakım ünitesinde yatan hastaların prognozunun değerlendirmesinde APACHE IV modelinin etkinliğinin araştırılması

Bu çalışmanın amacı, göğüs kalp damar cerrahi yoğun bakım ünitesinde izlediğimiz koroner arter By-Pass greftleme operasyonu geçiren hastalar dışındaki kardiyak sorunu olan olgularda Acute Physiology and Chronic Health Evaluation IV (APACHE IV) skorlarına göre beklenen ve gözlenen mortalite hızlarını karşılaştırmaktır. Materyal ve Metot: Entübasyon ve mekanik ventilasyon gerekliliği ile yoğun bakım ünitesine kabul edilen 118 erişkin olgunun prospektif olarak toplanan verileri analiz edildi. İlk 24 saatteki en kötü fizyolojik verilere göre APACHE IV skoru hesaplandı. APACHE IV sistemine göre düzeltilmiş beklenen mortalite hızları hesaplandı. Göğüs kalp damar cerrahi yoğun bakım ünitesinde gözlediğimiz mortalite hızı kaydedildi. Sonuçlar: Olguların (40 kadın/78 erkek) yaş ortalaması 63,3±16 idi. Olguların APACHE IV skoru ortalaması ortalaması 102,00±27,12 idi. Olguların akut fizyolojik skor ortalaması 90,78±25,64 idi. Olguların APACHE IV skoruna göre tahmini yoğun bakım kalış süresi ortalaması 4,71±1,62 gün idi. Olguların APACHE IV skoruna göre tahmini ölüm oranı ortalaması %61±%25 idi. Eksitus olan olguların APACHE skoru, taburcu olan olgulara göre yüksek bulundu (p

Investigation of the effectiveness of the APACHE IV Model for the evaluation of prognosis in the intensive care unit patients

Aim of this study is to compare observed and predicted mortality rate regarding to Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scores for cases followed in cardio-vasculer-thoracic surgical intensive care unit except from coronary by-pass grafting patients. Material and Methods: Prospectively collected data of 118 adults who were admitted to the intensive care unit with the need for intubation and mechanic ventilation were analyzed. The worst values of the physiological data in the first cardiovasculer-thoracic surgical intensive care unit day were used for calculations of APACHE IV scores. Adjusted predicted mortality rate according to APACHE IV scoring system was determined. Observed mortality rate in cardio-vasculer-thoracic surgical intensive care unit was recorded. Results: Mean age of cases (40 female/78 male) was 63.3±16 years. Mean APACHE IV and Acute Physiological Score (APS) were calculated as 102.00±27.12 90 and 78±25.64 respectively. According to the APACHE IV, the estimated average length of stay in intensive care was 4.71±1.62 days and the estimated average mortality rate was 61%±25%. APACHE IV score of the exitus patients was significantly higher than discharged patients (p<0.001). Exitus patients APACHE IV estimated mortality rate was significantly higher than discharged patients (p<0.01). Conclusion: APACHE IV-predicted mortality rate and cardio-vascular-thoracic surgical intensive care unit mortality were similar in our analysis. We thought that APACHE IV scoring system could be used successfully in predicting mortality rate and evaluating efficacy of treatment in cardiovasculer throacic surgical intensive care unit

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Yeni Tıp Dergisi-Cover
  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: -
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