Acil Serviste inme tanısı almış olan 65 yaş ve üstü hastaların karşılaştırılması
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Date
2012
Authors
İnal, Taylan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Dünyadaki yaşlı nüfusu giderek artmaktadır. Yaşlılar, acil servis hizmeti açısından özellikli bir grubu oluştururlar. Bu çalışmada Uludağ Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi'ne 01/01/2011-29/02/2012 tarihleri arasında başvurmuş olan 65 yaş ve üzerindeki inme tanısı alan hastaların verilerine ulaşılarak demografik, klinik ve patolojik özellikleri incelenmiş ve yaş grupları arasında bu özellikleri karşılaştırılmıştır. Çalışma sonuçlarımıza göre 65-74, 75-84 ve 85 yaş grupları arasında cinsiyet (p=0.24), başvuru şikayetleri (p=0.98), şikayet süreleri (p=0.40), komorbiditeleri (p=0.15) arasında anlamlı fark saptanmamıştır.Fizik muayene bulguları olan göz hareketleri (p=0.15), görme alanları (p=0.19), fasiyal sinir muayeneleri (p=0.51),üst ekstremite motor fonksiyonları (p=0.14), alt ekstremite motor fonksiyonları (p=0.29), ataksi (p=0.55),ihmal (p=0.34),afazi (p=0.27),dizartri (p=0.84),NIHSS skorları (p=0.18) arasında istatistiksel olarak anlamlı bir fark görülmemiştir.Tanıları (p=0.43),BBT'deki infarkt dönemleri (p=0.19), MRG'da saptanan damar patolojileri (0.54), MR'da saptanan infarkt lokalizasyonları (p=0.74), MRG'da infarkt dönemleri (p=0.36), MR'da infarkt tarafı (p=0.83), EKG bulguları (p=0.22) arasında da istatistiksel olarak anlamlı bir fark saptanmamıştır. Aynı zamanda hospitalize edildikleri bölümler (p=0.25) ve hospitalizasyon sonuçları (p=0.15), acil serviste kalış süreleri (p=0.72), klinikte yatış süreleri (p=0.61) ve trombolitik tedavi verilme oranlarındada istatistiksel olarak anlamlı bir fark tespit edilmemiştir.Yapılan istatistiksel analizlerde yaş grupları arasında fark gösteren parametreler ise bilinç durumları (p=0.002), duyu muayeneleri (p=0.001) ve BBT'de infarkt (p=0.037) ve kanama tarafları (p=0.046) idi. Çalışmamızın sonuçlarına göre ilerleyen yaşla birlikte inme etiyolojisinin değişim gösterebildiği, ancak klinik özellikler ve hasta sonuçları bakımından istatistiksel olarak belirgin farklar izlenmediğini gördük. Bizim çalışmamızda sevk edilen hastaların çokluğu ve bu gruptaki hastaların yoğun bakım ve klinik kalış süreleri ayrıca mortaliteleri yeterince aydınlatılamamış olup çok merkezli ve vaka sayısının yüksek olduğu yeni çalışmalarla desteklenebileceği kanaatindeyiz.
Elderly population in the World has been increasing gradually. In terms of emergency service, the elderly constitute a special group. By obtaining the data of the patients with stroke diagnosis, who are 65 and over the age of 65 and who applied to Uludağ University Medicine Faculty Emergency Department between 01.01.2011 and 29.02.2012, demographic, clinical, and pathological characteristics were investigated and then compared among age groups in this study. According to the study results, among the age groups of 65-74, 75-84 and 85, significant difference was not found out between gender (p=0.24), complaints for application (p=0.98), duration of complaints (p=0.40), and comorbidities (p=0.15). Similarly, among physical examination findings such as eye movements (p=0.15), visual fields (p=0.19), facial nerve examinations (p=0.51), upper extremity motor functions (p=0.14), lower extremity motor functions (p=0.29), ataxia (p=0.55), negligence (p=0.34), aphasia (p=0.27), dysarthria (p=0.84), and NIHSS scores (p=0.18), statistically significant difference was not established. Besides, no significant difference was found among diagnoses (p=0.43), infarct periods in BBT (p=0.19), vein pathologies detected in MR (p=0.54), infarct localizations detected in MR (p=0.74), infarct periods in MR (p=0.36), infarct side in MR (p=0.83), and EKG findings (p=0.22). In the same time, no significant differences were observed among the departments where the patients were hospitalised (p=0.25), the results of hospitalization (p=0.15), duration spent in emergency department (p=0.72), duration of hospitalization in clinic (p=0.61), and the rate of thrombolytic therapy given to the patients. Following the statistical analyses, the parameters revealing significant differences among age groups were conscious status (p=0.002), sense examinations (p=0.001), infarct in BBT (p=0.037), and bleeding sides (p=0.046). As a result of our study, we have seen that etiology of stroke may alter along with advancing age, however; in terms of clinical characteristics and patient results statistically significant differences were not observed. In the present study, the majority of the patients transferred and hospitalization duration of the patients in this group in intensive care and in clinics and also their mortality have not been clarified enough. Therefore, we are of opinion that this may be supported by new studies which are multi-centred and having large number of cases.
Elderly population in the World has been increasing gradually. In terms of emergency service, the elderly constitute a special group. By obtaining the data of the patients with stroke diagnosis, who are 65 and over the age of 65 and who applied to Uludağ University Medicine Faculty Emergency Department between 01.01.2011 and 29.02.2012, demographic, clinical, and pathological characteristics were investigated and then compared among age groups in this study. According to the study results, among the age groups of 65-74, 75-84 and 85, significant difference was not found out between gender (p=0.24), complaints for application (p=0.98), duration of complaints (p=0.40), and comorbidities (p=0.15). Similarly, among physical examination findings such as eye movements (p=0.15), visual fields (p=0.19), facial nerve examinations (p=0.51), upper extremity motor functions (p=0.14), lower extremity motor functions (p=0.29), ataxia (p=0.55), negligence (p=0.34), aphasia (p=0.27), dysarthria (p=0.84), and NIHSS scores (p=0.18), statistically significant difference was not established. Besides, no significant difference was found among diagnoses (p=0.43), infarct periods in BBT (p=0.19), vein pathologies detected in MR (p=0.54), infarct localizations detected in MR (p=0.74), infarct periods in MR (p=0.36), infarct side in MR (p=0.83), and EKG findings (p=0.22). In the same time, no significant differences were observed among the departments where the patients were hospitalised (p=0.25), the results of hospitalization (p=0.15), duration spent in emergency department (p=0.72), duration of hospitalization in clinic (p=0.61), and the rate of thrombolytic therapy given to the patients. Following the statistical analyses, the parameters revealing significant differences among age groups were conscious status (p=0.002), sense examinations (p=0.001), infarct in BBT (p=0.037), and bleeding sides (p=0.046). As a result of our study, we have seen that etiology of stroke may alter along with advancing age, however; in terms of clinical characteristics and patient results statistically significant differences were not observed. In the present study, the majority of the patients transferred and hospitalization duration of the patients in this group in intensive care and in clinics and also their mortality have not been clarified enough. Therefore, we are of opinion that this may be supported by new studies which are multi-centred and having large number of cases.
Description
Keywords
Acil servis, İnme, 65 yaş üstü, Hasta özellikleri, Emergency Department, Stroke, Over the age of 65, Patient characteristics
Citation
İnal, T. (2012). Acil Serviste inme tanısı almış olan 65 yaş ve üstü hastaların karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.