Acil serviste kan transfüzyonu yapılan hastaların özellikleri
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Date
2019-10-11
Authors
İşler, Yeşim
Kaya, Halil
İşler, Şükrü
Yüksel, Melih
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı acil serviste kan ve kan ürünleri transfüzyonu yapılan hastaların transfüzyon sonrası değişim verilerin incelenmesi amacıyla prospektif olarak incelemektir. Bu çalışma Sağlık Bilimleri Üniversitesi Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi acil servisine başvuran hastaların yaş ve cinsiyetleri, şikayetleri, muayene bulguları, kan grupları, verilen kan ürünleri ve ünitelerinin dağılımı, transfüzyon öncesi ve sonrası hemoglobin(Hb), hematokrit (Hct) değerleri incelenerek yapıldı. Çalışmaya 92 hasta alınmış olup hastaların %56,5’u 65 yaş ve üzerindeydi. %59,8’i kadındı. %44,6 ile en fazla “halsizlik” şikayeti vardı. Muayenede hastaların %17,4’inde melena %14,1’inde hematokezya vardı. Hastaların %40,2’si anemi ve %35,9’u Gastrointestinal Sistem (GİS) kanaması tanısı almıştı. Hastalar en fazla %45,7 ile A RH+ ve %29,3 ile 0 RH + kan gruplarına sahipti. Hastaların %94,6’sına eritrosit süspansiyonu (ES) ve %5,4’üne ES+ taze donmuş plazma (TDP) transfüzyonu yapıldı. Hastaların %46,7’sine iki ünite ES ve %40,2’sine bir ünite ES verildi. Yaş gruplarının transfüzyon öncesi Hb değerleri arasında istatistiksel olarak önemli bir fark yokken (p=0,879), transfüzyon sonrası istatistiksel olarak önemli fark olduğu bulundu (p=0,003). ES transfüzyonu sonrası hastaların %58,2’si beklenen Hb değerine ve %50,0’si beklenen Hct değerlerine ulaşmıştı. Yaş, cinsiyet ve tanıya göre beklenen Hb ve Hct düzeylerine ulaşma durumları arasında istatistiksel olarak önemli fark yoktu (p>0,05). Transfüzyon öncesi ve sonrası hastaların nabız, tansiyon ve ateş gibi vital bulgularında istatistiksel olarak fark yoktu (p>0,05), ancak Hb, Hct, MCV ve MCH’de önemli artış vardı (p<0,05). Çalışma sonunda acil serviste yapılan kan ve kan ürünü transfüzyonları incelendiğinde düşünülenin aksine travmaya bağlı acil transfüzyon değil de en fazla GİS kanama ve anemiye bağlı transfüzyon yapıldığı tespit edilmiştir.
The aim of this study was to prospectively examine the level of change in patients who received blood transfusion and blood products in the emergency department. This study was carried out in Health Sciences University Bursa Higher Specialization Training and Research Hospital Emergency Medicine Clinic between 15.01.2017 and 15.04.2017. Age, gender, complaints, examination findings, blood groups, distribution of blood products and units, and pre- and post-transfusion hemoglobin (Hb) and hematocrit (Hct) levels were investigated. 92 patients were included in the study. 56.5% of the patients were 65 years or older. 59.8% were female. The most common complaint was weakness (44.6%). During examination, it was found that 17.4% of the patients had melena and 14.1% had hematochezia. 40.2% of the patients were diagnosed as anemia and 35.9% were diagnosed with gastrointestinal system bleeding. The most common blood group was A RH + (45.7%) and 0 RH + (29.3%). 94.6% of the patients underwent erythrocyte suspension (ES) and 5.4% had ES + fresh frozen plasma (TDP) transfusion. 46.7% of the patients received two units of ES and 40.2% received one unit of ES. While there was no statistically significant difference between the Hb values of the age groups before transfusion (p = 0.879), there was a statistically significant difference after transfusion (p = 0.003). After ES transfusion, 58.2% of the patients had an expected Hb value and 50.0% had an expected Hct value. There was no statistically significant difference between Hb and Hct levels in terms of age, gender and diagnosis (p> 0.05). There was no statistically significant difference in vital signs such as pulse, blood pressure and fever before and after transfusion (p> 0.05), but there was a significant increase in Hb, Hct, MCV and MCH (p <0.05). In conclusion, when blood and blood product transfusions in the emergency department were examined, it was found that most common transfusions were GIS bleeding and anemia-related transfusions rather than trauma-induced emergency transfusions, which was contrary to the expectations.
The aim of this study was to prospectively examine the level of change in patients who received blood transfusion and blood products in the emergency department. This study was carried out in Health Sciences University Bursa Higher Specialization Training and Research Hospital Emergency Medicine Clinic between 15.01.2017 and 15.04.2017. Age, gender, complaints, examination findings, blood groups, distribution of blood products and units, and pre- and post-transfusion hemoglobin (Hb) and hematocrit (Hct) levels were investigated. 92 patients were included in the study. 56.5% of the patients were 65 years or older. 59.8% were female. The most common complaint was weakness (44.6%). During examination, it was found that 17.4% of the patients had melena and 14.1% had hematochezia. 40.2% of the patients were diagnosed as anemia and 35.9% were diagnosed with gastrointestinal system bleeding. The most common blood group was A RH + (45.7%) and 0 RH + (29.3%). 94.6% of the patients underwent erythrocyte suspension (ES) and 5.4% had ES + fresh frozen plasma (TDP) transfusion. 46.7% of the patients received two units of ES and 40.2% received one unit of ES. While there was no statistically significant difference between the Hb values of the age groups before transfusion (p = 0.879), there was a statistically significant difference after transfusion (p = 0.003). After ES transfusion, 58.2% of the patients had an expected Hb value and 50.0% had an expected Hct value. There was no statistically significant difference between Hb and Hct levels in terms of age, gender and diagnosis (p> 0.05). There was no statistically significant difference in vital signs such as pulse, blood pressure and fever before and after transfusion (p> 0.05), but there was a significant increase in Hb, Hct, MCV and MCH (p <0.05). In conclusion, when blood and blood product transfusions in the emergency department were examined, it was found that most common transfusions were GIS bleeding and anemia-related transfusions rather than trauma-induced emergency transfusions, which was contrary to the expectations.
Description
Keywords
Kan, Kan ürünü, Transfüzyon, Acil, Blood, Blood product, Transfusion, Emergency
Citation
İşler, Y. vd. (2019). "Acil serviste kan transfüzyonu yapılan hastaların özellikleri". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(3), 275-280.