Acil Servise başvuran onkolojik veya hematolojik maligniteli hastalarda modifiye erken uyarı skoru (MEWS) ile mortalite ve morbiditenin belirlenmesi
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Date
2012
Authors
Aygün, Hüseyin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Kritik hastaların büyük kısmı ilk olarak acil servislere başvururlar ve ilk tedavileri acil servislerde başlanır. Kritik hastalar hızlı şekilde belirlenmez ve tedavisine başlanmazsa kısa sürede kötüleşebilmektedirler. Acil servislere başvuruları giderek artan ve potansiyel kritik hasta sınıfında olan kanser hastalarının ayrımının hızlı ve etkin bir şekilde yapılması gerekmektedir. Bu çalışmada genel hasta popülasyonunda etkin olduğu gösterilmiş olan hastaların acil başvurularında MEWS'in kanser hastalarında 30 gün içindeki mortalite ve morbiditenin belirlemesinde kullanışlı olup olmadığı ve skor değerlerinin genel hasta değerleriyle karşılaştırılması amaçlandı.Çalışmamız 01.02.2012-01.05.2012 tarihleri arasında Uludağ Üniversitesi Acil Servisine başvuran onkolojik ve ya hematolojik malignitesi olan 501 hasta kayıt altına alınarak yapıldı.Hastaların yaş ortalaması 59.2±13.5 olup, %58.9'u erkektir. Tüm hastalarda MEWS ortalaması 3.05 olup, bu değer 30 gün içinde sağ kalanlarda 1.66, ölen hastalarda ise 6.67 olarak saptanmıştır, MEWS ile yaşama durumu arasındaki ilişki istatiksel olarak anlamlı bulundu. (p<0.001). Ayrıca genel hasta popülasyonunda MEWS için ortalama 4 ve üstü değerler yüksek riskli hasta olarak bildirilmekte iken, bizim çalışmamızda kanser hastaları için bu değerin 2 olduğunu saptadık.Kanser hastalarının acil servislere hayatı tehdit edici ve geri döndürülebilir pek çok nedenle başvururlar. Çalışmamızda bu hasta grubunun acil servis başvurusu esnasındaki MEWS değeri ile 30 günlük mortalite arasında ilişki olduğunu saptadık. Bu hastaların acil servis başvurularında MEWS'in rutin olarak kullanılması ve bu değeri 2 ve üzerinde olan hastaların kritik hasta grubunda değerlendirilmesi gerekmektedir.
Most of the critical patients come to emergency departments firstly. And first treatments start at the emergency departments. If critical patients don’t be detected and started to be treated, they deteriorate fastly. Cancer patients ,who are potentially critical patients and increasingly come to emergency departments, must be discriminated fastly and efficiently. In this study the aim is to understand if the MEWS-which has been showen to be useful in general patient population- is usefull or not in determinating the morbidity and the mortality in 30 days, for cancer patients coming emergency departments and to compare the score rates with the general patients’s rates. Our study was made by recording the 501 patients with oncologic or hematologic malignities who have come to the Emergency Department of Medical Faculty of Uludağ University between the dates of 1.2.2012 and 1. 5. 2012. The patients’s average of age was 59.2+/- 13.5. 58.9% Of the patients was males. In all patients average MEWS was 3,05 ; in the patients who survived in 30 days, that value was 1.66 ; and in the patients who died in 30 days, it was 6.67. Relationship between MEWS and the survival was found statistically significant( p<0.001). Also, while 4 and higher average values of MEWS are declared as high-risk for general patient population, in our study, for the cancer patients, we determined that value as 2. Cancer patients, come to emergency departments with many reversible and life threatening reasons. In our study, we determined a relationship between 30 days mortality and MEWS value of that patient group while entering the emergency department. It is necessary to use MEWS routinely in these patients and to evaluate the values that are 2 and over in critical patient group.
Most of the critical patients come to emergency departments firstly. And first treatments start at the emergency departments. If critical patients don’t be detected and started to be treated, they deteriorate fastly. Cancer patients ,who are potentially critical patients and increasingly come to emergency departments, must be discriminated fastly and efficiently. In this study the aim is to understand if the MEWS-which has been showen to be useful in general patient population- is usefull or not in determinating the morbidity and the mortality in 30 days, for cancer patients coming emergency departments and to compare the score rates with the general patients’s rates. Our study was made by recording the 501 patients with oncologic or hematologic malignities who have come to the Emergency Department of Medical Faculty of Uludağ University between the dates of 1.2.2012 and 1. 5. 2012. The patients’s average of age was 59.2+/- 13.5. 58.9% Of the patients was males. In all patients average MEWS was 3,05 ; in the patients who survived in 30 days, that value was 1.66 ; and in the patients who died in 30 days, it was 6.67. Relationship between MEWS and the survival was found statistically significant( p<0.001). Also, while 4 and higher average values of MEWS are declared as high-risk for general patient population, in our study, for the cancer patients, we determined that value as 2. Cancer patients, come to emergency departments with many reversible and life threatening reasons. In our study, we determined a relationship between 30 days mortality and MEWS value of that patient group while entering the emergency department. It is necessary to use MEWS routinely in these patients and to evaluate the values that are 2 and over in critical patient group.
Description
Keywords
MEWS, Acil Servis, Kanser, Emergency Department, Cancer
Citation
Aygün, H. (2012). Acil Servise başvuran onkolojik veya hematolojik maligniteli hastalarda modifiye erken uyarı skoru (MEWS) ile mortalite ve morbiditenin belirlenmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.