Acil serviste kritik hastaların değerlendirilmesinde kullanılan skorlama sistemlerinin geriatrik hasta popülasyonunda değerliliği
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Date
2017-03-17
Authors
Çetinkaya, Hasan Basri
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada acil servis (AS)’e başvuran kritik hastaların değerlendirilmesinde kullanılan çeşitli skorlama sistemlerinin geriatrik hasta popülasyonu için değerliliğinin araştırılması amaçlanmıştır. Uludağ Üniversitesi Tıp Fakültesi Hastanesi AS`ine başvuran, 65 yaş ve üstü hastalar çalışmaya dahil edilerek, tüm hastalar için HOTEL, ViEWS, ViEWS-L, MEWS, RAPS, REMS skorları hesaplanarak kaydedilmiştir. Çalışmaya 350’si erkek (%56.8), ve 266’sı (%43.2) kadın olmak üzere toplam 616 hasta alındı. Hastaların sonuçlanma şekillerine göre yapılan karşılaştırılmalarında; ilk 24 saatte mortalite açısından tüm skorlar anlamlı saptandı. İkili karşılaştırılmalarında; yatış-taburculuk açısından tüm skorlar, yatış-eksitus açısından VIEWS-L ve RAPS skorları, taburcu-eksitus açısından ise, HOTEL skoru dışındaki tüm skorlar istatistiksel olarak anlamlıydı. 24 saatlik mortaliteyi etkileyen risk faktörlerinin belirlenmesi için HOTEL, ViEWS-L, ViEWS, RAPS, REMS ve MEWS skorları bağımsız değişkenler alınarak geriye doğru adımsal lojistik regresyon analizi yapıldığında elde edilen son modelde VİEWS, VİEWS-L ve RAPS değişkenleri anlamlı bulundu. Bu çalışma sonucunda AS’e başvuran geriatrik hastaların değerlendirilmesinde ve mortalite riskinin belirlenmesinde, kritik hastalarda kullanılan skorlama sistemlerinin kullanılmasının etkin olduğu kanısına varılmıştır.
It is aimed to make a study of valuableness of various scoring systems used for evaluation of critical patient presenting to the Emergency Department(ED) for geriatric patient population. HOTEL,VIEWS,VIEWS-L,MEWS, RAPS and REMS scores of all patients were calculated and recorded as including the patient who was aged 65 and over and presented to ED of Uludag University Medical Faculty Hospital. A total of 616 patients, 350(%56.8) of whom were male and 266(%43.2) were female, were included in the study. In comparison made according to the situations of patients, all scores are found as significant with regard to mortality in first 24 hours. In pairwise comparisons, all scores for admission-discharge, VIEWS-L and RAPS scores for admission-exitus, all scores except HOTEL for discharge-exitus were statistically significant. In order to determine the risk factors affecting the 24 hours mortality, when backward stepwise logistic regression analysis was made while considering HOTEL, VIEWS-L, VIEWS, RAPS, REMS and MEWS scores as independent variables,VIEWS,VIEWS-L and RAPS scores were found as significant in the last obtained model. As a result of this study, it is concluded that using the scoring systems used for critical patients is effective for evaluation and determining the mortality risk of geriatric patients.
It is aimed to make a study of valuableness of various scoring systems used for evaluation of critical patient presenting to the Emergency Department(ED) for geriatric patient population. HOTEL,VIEWS,VIEWS-L,MEWS, RAPS and REMS scores of all patients were calculated and recorded as including the patient who was aged 65 and over and presented to ED of Uludag University Medical Faculty Hospital. A total of 616 patients, 350(%56.8) of whom were male and 266(%43.2) were female, were included in the study. In comparison made according to the situations of patients, all scores are found as significant with regard to mortality in first 24 hours. In pairwise comparisons, all scores for admission-discharge, VIEWS-L and RAPS scores for admission-exitus, all scores except HOTEL for discharge-exitus were statistically significant. In order to determine the risk factors affecting the 24 hours mortality, when backward stepwise logistic regression analysis was made while considering HOTEL, VIEWS-L, VIEWS, RAPS, REMS and MEWS scores as independent variables,VIEWS,VIEWS-L and RAPS scores were found as significant in the last obtained model. As a result of this study, it is concluded that using the scoring systems used for critical patients is effective for evaluation and determining the mortality risk of geriatric patients.
Description
Keywords
Geriatrik hasta, Skorlama sistemleri, Acil servis, Geriatric patient, Scoring systems, Emergency department
Citation
Köksal, Ö. ve Çetinkaya, H. B. (2017). "Acil serviste kritik hastaların değerlendirilmesinde kullanılan skorlama sistemlerinin geriatrik hasta popülasyonunda değerliliği". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 43(2), 61-66.