Publication: Acil servise akut KOAH alevlenmesi ile başvuran ve hiperkarbik solunum yetmezliği olan hastalarda hastane içi mortaliteye etki eden faktörlerin retrospektif olarak değerlendirilmesi
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Çoşkun, Nur Betül
Advisor
Durak, Vahide Aslıhan
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Bursa Uludağ Üniversitesi
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Abstract
Amaç: Bu çalışmada amacımız acil servis hekimi için hiperkarbik koah alevlenme ile acil servise başvuran hastaların prognoz ve hastane içi mortalitesinin daha hızlı ve etkin şekilde değerlendirilmesini sağlayacak parametreleri değerlendirerek literatüre katkıda bulunmaktır. Metod: Kesitsel tipte olan bu çalışma 01.06.2019 - 01.06.2023 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi erişkin acil servisine hiperkarbik KOAH atak tanısı ile başvuran hasta dosyalarının, retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Bulgular: Araştırmada değerlendirilen 270 vakanın 74’ü kadın 196’sı erkektir. Çalışmaya katılan hastalar içerisinde bilinç durumu, vitalleri, kan gazı, hemogram değerleri, biyokimya ve koagülasyon testleri, komorbiditeleri değerlendirilmiş olup pH, eozinofil artışının mortaliteyi azalttığı; bilinç durumu, PCO2, BUN, d-dimer, troponin, CRP, platelet, INR, aPTT parametrelerinin mortaliteyi arttırdığı bulundu. Sonuç: Çalışmamızda hiperkarbik KOAH alevlenmesi ile acil servise başvuran hastalarının klinik progresyonu öngörmede hızlı ve etkin karar verilebilmesi için hastanın demografik özellikleri, vital bulguları ve laboratuvar parametrelerinin mortalite üzerine etkisi hekimler tarafından iyi anlaşılmalı ve konu ile ilgili literatüre katkı sunan çalışmaların sayısı arttırılmalıdır.
Objective: The aim of this study is to contribute to the literature by evaluating parameters that enable a faster and more effective assessment of prognosis and in-hospital mortality of patients presenting to the emergency department with hypercapnic COPD exacerbations. Method: This cross-sectional study was conducted through a retrospective review of patient files diagnosed with hypercapnic COPD exacerbations, admitted to the adult emergency department of Bursa Uludağ University Faculty of Medicine Hospital between June 1, 2019, and June 1, 2023. Results: Among the 270 cases evaluated in the study, 74 were female and 194 were male. Various parameters including consciousness level, vital signs, blood gas values, hemogram, biochemical and coagulation tests, and comorbidities were assessed. The study found that an increase in pH and eosinophil count was associated with reduced mortality, while consciousness level, PCO2, BUN, d-dimer, troponin, CRP, platelet count, INR, and aPTT were associated with increased mortality. Conclusion: For effective and timely decision-making in predicting the clinical progression of patients presenting with hypercapnic COPD exacerbations in the emergency department, it is crucial for physicians to understand the impact of the patient's demographic characteristics, vital signs, and laboratory parameters on mortality. Furthermore, there is a need for increased research in this area to enhance the existing literature.
Objective: The aim of this study is to contribute to the literature by evaluating parameters that enable a faster and more effective assessment of prognosis and in-hospital mortality of patients presenting to the emergency department with hypercapnic COPD exacerbations. Method: This cross-sectional study was conducted through a retrospective review of patient files diagnosed with hypercapnic COPD exacerbations, admitted to the adult emergency department of Bursa Uludağ University Faculty of Medicine Hospital between June 1, 2019, and June 1, 2023. Results: Among the 270 cases evaluated in the study, 74 were female and 194 were male. Various parameters including consciousness level, vital signs, blood gas values, hemogram, biochemical and coagulation tests, and comorbidities were assessed. The study found that an increase in pH and eosinophil count was associated with reduced mortality, while consciousness level, PCO2, BUN, d-dimer, troponin, CRP, platelet count, INR, and aPTT were associated with increased mortality. Conclusion: For effective and timely decision-making in predicting the clinical progression of patients presenting with hypercapnic COPD exacerbations in the emergency department, it is crucial for physicians to understand the impact of the patient's demographic characteristics, vital signs, and laboratory parameters on mortality. Furthermore, there is a need for increased research in this area to enhance the existing literature.
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Keywords
KOAH, Mortalite, Acil servis, COPD, Mortality, Emergency department