Akut serebrovasküler hastalık tanısı ile takip edilen hastalardaki sıvı elektrolit dengesizliklerinin analizi
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Date
2022-11-01
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Bursa Uludağ Üniversitesi
Abstract
Serebrovasküler hastalık; aniden ortaya çıkan fokal ya da global serebral disfonksiyona yol açan, vasküler neden dışında görünen farklı bir sebebi olmayan, yirmi dört saat veya daha uzun süren ya da ölüme sebep olan klinik durum olarak tanımlanmaktadır. Elektrolit bozuklukları akut fazın sonuçları üzerinde olumsuz etkilere sahip olabilmekte ve bu sebeple elektrolit bozukluğunun erken tespiti ve tedavi edilmesi son derece önemli olarak görülmektedir. Çalışmamızın amacı serebrovasküler hastalık alt tipleri ile elektrolit dengesizlikleri arasındaki ilişkiyi incelemektir. Bursa Uludağ Üniversitesi Tıp Fakültesi Acil Servisi’ne 1.03.2017-1.03.2022 arasında başvurup akut serebrovasküler hastalık tanısı alan 128 hasta çalışmamıza dahil edilmiştir. Hastaların demografik özellikleri, hastane başvuru saatleri, radyolojik görüntülemeleri, sodyum, potasyum, klor, glukoz, üre, kreatinin, hemogram, ek hastalıkları, vital bulguları (ateş, nabız, tansiyon değerleri, parmak ucu saturasyonu, solunum sayısı ve GKS Skoru) ve klinik seyirleri retrospektif olarak incelenmiştir. Çalışmamızda hiponatremik olan hastaların 11 tanesi (%57,9) iskemik, 8 tanesi (%42,1) hemorajik serebrovasküler hastalığı olan grupta olup her iki hasta grubunda ortalama sodyum değerleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark çıkmamıştır. Hipokalemik hastaların 3 tanesi (%75) iskemik grupta, 1 tanesi (%25) hemorajik grupta olup her iki hasta grubunda ortalama potasyum değerleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark çıkmamıştır. Hipokloremi saptanan hastaların ise 5 tanesi (%62,5) iskemik, 3 tanesi (%37,5) hemorajik grupta yer almakta olup her iki hasta grubunda ortalama klor değerleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark çıkmamıştır. Sonuç olarak akut serebrovasküler hastalıklarda elektrolit değişikliklerini incelediğimiz bu çalışmada hemorajik tip ve iskemik tipteki serebrovasküler hastalıklarda elektrolit dengesizliklerinin klinik seyir ve mortalite üzerinde etkisi olmadığı görülmektedir.
Cerebrovascular disease is defined as a clinical condition that causes sudden onset of focal or global cerebral dysfunction that has no apparent cause other than a vascular cause and lasting for 24 hours or longer, or causes death. Electrolyte disturbances can have adverse effects on the outcome of the acute phase of cerebrovascular disease. Regarding this, early detection and treatment of electrolyte disturbance is considered extremely important. The aim of our study is to examine the relationship between cerebrovascular disease subtypes and electrolyte imbalance. 128 patients who applied to Bursa Uludağ University Medical Faculty Emergency Medicine Department between 1.03.2017-1.03.2022 with diagnosis of acute cerebrovascular disease were included in our study. Demographic characteristics of patients, hospital admission times, radiological imaging, sodium, potassium, chlorine, glucose, urea, creatinine, hemogram, comorbidities, vital signs (fever, pulse, blood pressure values, oxygen saturation, respiratory rate and GCS value) and their clinical course were analyzed retrospectively. In our study, 11 (57.9%) of the hyponatremic patients were in the ischemic group and 8 (42.1%) were in the hemorrhagic cerebrovascular disease group, and there was no statistically significant difference when the mean sodium values were compared in both patient groups. Three (75%) of the hypokalemic patients were in the ischemic group and one (25%) was in the hemorrhagic group. When the mean potassium values were compared in both patient groups, no statistically significant difference was found.In hypochloremia group, 5 patients (62.5%) were in the ischemic group and 3 (37.5%) were in the hemorrhagic group, and there was no statistically significant difference when the mean chloride values were compared in both patient groups. In conclusion, due to our study, electrolyte imbalances did not yield significant results both on clinical course and mortality in hemorrhagic type and ischemic type cerebrovascular diseases.
Cerebrovascular disease is defined as a clinical condition that causes sudden onset of focal or global cerebral dysfunction that has no apparent cause other than a vascular cause and lasting for 24 hours or longer, or causes death. Electrolyte disturbances can have adverse effects on the outcome of the acute phase of cerebrovascular disease. Regarding this, early detection and treatment of electrolyte disturbance is considered extremely important. The aim of our study is to examine the relationship between cerebrovascular disease subtypes and electrolyte imbalance. 128 patients who applied to Bursa Uludağ University Medical Faculty Emergency Medicine Department between 1.03.2017-1.03.2022 with diagnosis of acute cerebrovascular disease were included in our study. Demographic characteristics of patients, hospital admission times, radiological imaging, sodium, potassium, chlorine, glucose, urea, creatinine, hemogram, comorbidities, vital signs (fever, pulse, blood pressure values, oxygen saturation, respiratory rate and GCS value) and their clinical course were analyzed retrospectively. In our study, 11 (57.9%) of the hyponatremic patients were in the ischemic group and 8 (42.1%) were in the hemorrhagic cerebrovascular disease group, and there was no statistically significant difference when the mean sodium values were compared in both patient groups. Three (75%) of the hypokalemic patients were in the ischemic group and one (25%) was in the hemorrhagic group. When the mean potassium values were compared in both patient groups, no statistically significant difference was found.In hypochloremia group, 5 patients (62.5%) were in the ischemic group and 3 (37.5%) were in the hemorrhagic group, and there was no statistically significant difference when the mean chloride values were compared in both patient groups. In conclusion, due to our study, electrolyte imbalances did not yield significant results both on clinical course and mortality in hemorrhagic type and ischemic type cerebrovascular diseases.
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Keywords
Serebrovasküler hastalık, Hiponatremi, Hipokloremi, Hipokalemi, Cerebrovascular disease, Hyponatremia, Hypochloremia, Hypokalemia
Citation
Sezer, O. vd. (2022). ''Akut serebrovasküler hastalık tanısı ile takip edilen hastalardaki sıvı elektrolit dengesizliklerinin analizi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 48(3), 307-313.