Yoğun Bakım Ünitemizden Exitus Olarak Taburcu Edilen Hastaların Analizi: Üçüncü Basamak Merkezimizin Bir Yıllık Verileri
Abstract
ÖZ
Amaç: Hastanemiz Yoğun Bakım Ünitesi’ne (YBÜ) 1 Mayıs 2017- 31 Mayıs 2018
tarihleri arasında kabul edilen ve exitus gerçekleşen hastaların demografik verilerini, YBÜ kabul nedeni ve kalış
süresi ile exitus nedenlerini tespit etmektir.
Araçlar ve Yöntem: Kurum izni ve etik kurul izni alındıktan sonra hastanemizin YBÜ’ne kabul
edilmiş olan ve exitus gerçekleşen hastaların tıbbi kayıtları geriye dönük olarak incelenmiştir.
Çalışmada 434 hastanın verileri analiz edilmiştir. Hastaların yaş ve
cinsiyetleri, yoğun bakıma yatış saatleri ve mesai dilimi, exitus kabul edildiği saat, hangi servis adına
yatış yapıldığı, yatış endikasyonları, YBÜ’de kalış süreleri ve primerexitus nedenleri kaydedilmiştir.
Bulgular: 1 Mayıs 2017 – 31 Mayıs 2018 arasında YBÜ’ne toplam1331 hasta kabul
edilmiş ve bu hastaların 434’ünde (%32.6) exitus gerçekleşmiştir. Hastaların yaş ortalaması 72.82
± 15.81 idi. En sık ölümler 139 hasta ile (%32) 80 – 89 yaş aralığında tespit
edildi. Exitus olan hastaların
201’i kadın (%46), 233’ü erkekti (%54). Hastaların YBÜ’ne en sık kabul edildiği
saatler 13:00 ve 15:00 aralığındaydı. Rapor edilen en sık exitus nedeni kardiyovasküler hastalıklar (n
=222, %51.2) iken hastaların bağlı olduğu klinik en sık olarak (n = 105, %24.2)
Göğüs Hastalıkları Kliniği’ydi. Hastaların
%93.8’i hastaneye Acil Servis’ten giriş yapmış ve %6.2’si hastane içi
servislerden YBÜ’ne nakledilmiştir. Hastaların ortalama GKS skoru 8.4 ± 4.6.Hastalara ait tıbbi
kayıtlardan APACHE II skorları ve SOFA skorlarına ulaşılamamıştır.
Sonuç: Yoğun bakım ünitemizde mortalite oranları diğer birçok merkezden düşük
olmakla beraber hala yüksektir. İleri yaş ve komorbid hastalıkların varlığı bu sonuçlar üzerinde etkili olabilir.
References
- Referans 1. Brilli RJ, Spevetz A, Branson RD et al. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med 2001; 29:2007-19.
- Referans 2. Unal AU, Kostek O, Takir M, Caklili O, Uzunlulu M, Oguz A. Prognosis of patients in a medical intensive care unit. North Clin Istanb 2015; 2:189-95.
- Referans 3. Boumendil A, Somme D, Garrouste-Orgeas M, Guidet B. Should elderly patients be admitted to the intensive care unit? Intensive Care Med 2007; 33:1252.
- Referans 4. Boumendil A, Aegerter P, Guidet B, Network CU-R. Treatment intensity and outcome of patients aged 80 and older in intensive care units: a multicenter matched-cohort study. J Am Geriatr Soc 2005; 53:88-93.
- Referans 5. Garrouste-Orgeas M, Timsit JF, Montuclard L et al. Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission. Intensive Care Med 2006; 32:1045-51.
- Referans 6. Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr., Committee on Manpower for P, et al. Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA 2000; 284:2762-70.
- Referans 7. Seferian EG, Afessa B. Adult intensive care unit use at the end of life: a population-based study. Mayo Clin Proc 2006; 81:896-901.
- Referans 8. Orban JC, Walrave Y, Mongardon N et al. Cause and characteristics of death in intensive care units: a prospective multicenter study. Anesthesiology 2017; 126: 882-889.
- Referans 9. Ceylan E, İtil O, Arı G, Ellidokuz H, Uçan ES, Akkoçlu A. İç Hastalıkları Yoğun Bakım Ünitesinde İzlenmiş Hastalarda Mortalite ve Morbiditeyi Etkileyen Faktörler. Toraks Dergisi 2001; 2:6-12.
- Referans 10. Uysal N, Gündoğdu N, Börekçi Ş ve ark. Üçüncü basamak merkezde dahili yoğun bakım hastalarının prognozu. Yoğun Bakım Derg 2010; 1:1-5.
- Referans 11. Akkoç İ, Yücetaş E, İşitmez İ ve ark. Mortality rate in intensive care units of tertiary health institutions and identifying risk factors: analysis of 3945 patients. Bezmialem Science 2017; 5:116-20.
Analysis of Patients Discharged as Exitus from Intensive Care Unit: One Year Data of our Tertiary Health Institution
Abstract
ABSTRACT
Purpose: To determine the demographic data, length of stay at intensive care unit
(ICU), diagnosis at ICU admission and the cause of death in patients hospitalized in ICU from 1 May, 2017 to
31 May, 2018 at the end of their lives.
Materials and Methods: Medical files of 434 patients who stayed in ICU and discharged as exitus
were retrospectively analyzed. Age, gender, the time of ICU admission and declaration of death
(time, work period, and month), the department responsible for patient care,
indication for ICU admission, length of stay
in ICU, and primary cause of death of the patients were recorded.
Results: Total number of ICU admissions
in the study period was 1331 patients and 434 (32.6%) of them died. Mean age of
patients was 72.82 ± 15.81.
The incidence of death was most frequent between 80 – 89 years of age (n=139,
%32). 201 of the patients were female (46%) and 233 were male (54%). Patients were most frequently
admitted to ICU between 13:00 – 15:00 time period. Most frequent cause of death
was cardiovascular diseases (n=222, 51.2%)
although chest diseases was the most common department admitting patients to
ICU (n=105, 24.2%). Ninety three point eight percent of the patients admitted to
hospital from emergency department and 6.2% were transferred from wards. Mean
GKS of the patients was 8.4 ±
4.6. We could not reach the data of APACHE II Scores and SOFA Scores from the
medical fields of the patients.
Conclusion: Although mortality rates in our ICU are lower than other institutions, it
is still high. Increased age and the presence of comorbidities may play a role in this outcome.
References
- Referans 1. Brilli RJ, Spevetz A, Branson RD et al. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med 2001; 29:2007-19.
- Referans 2. Unal AU, Kostek O, Takir M, Caklili O, Uzunlulu M, Oguz A. Prognosis of patients in a medical intensive care unit. North Clin Istanb 2015; 2:189-95.
- Referans 3. Boumendil A, Somme D, Garrouste-Orgeas M, Guidet B. Should elderly patients be admitted to the intensive care unit? Intensive Care Med 2007; 33:1252.
- Referans 4. Boumendil A, Aegerter P, Guidet B, Network CU-R. Treatment intensity and outcome of patients aged 80 and older in intensive care units: a multicenter matched-cohort study. J Am Geriatr Soc 2005; 53:88-93.
- Referans 5. Garrouste-Orgeas M, Timsit JF, Montuclard L et al. Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission. Intensive Care Med 2006; 32:1045-51.
- Referans 6. Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr., Committee on Manpower for P, et al. Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA 2000; 284:2762-70.
- Referans 7. Seferian EG, Afessa B. Adult intensive care unit use at the end of life: a population-based study. Mayo Clin Proc 2006; 81:896-901.
- Referans 8. Orban JC, Walrave Y, Mongardon N et al. Cause and characteristics of death in intensive care units: a prospective multicenter study. Anesthesiology 2017; 126: 882-889.
- Referans 9. Ceylan E, İtil O, Arı G, Ellidokuz H, Uçan ES, Akkoçlu A. İç Hastalıkları Yoğun Bakım Ünitesinde İzlenmiş Hastalarda Mortalite ve Morbiditeyi Etkileyen Faktörler. Toraks Dergisi 2001; 2:6-12.
- Referans 10. Uysal N, Gündoğdu N, Börekçi Ş ve ark. Üçüncü basamak merkezde dahili yoğun bakım hastalarının prognozu. Yoğun Bakım Derg 2010; 1:1-5.
- Referans 11. Akkoç İ, Yücetaş E, İşitmez İ ve ark. Mortality rate in intensive care units of tertiary health institutions and identifying risk factors: analysis of 3945 patients. Bezmialem Science 2017; 5:116-20.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Articles |
| Authors | |
| Publication Date | August 26, 2019 |
| Published in Issue | Year 2019 Volume: 3 Issue: 2 |
Cite
Ahi Evran Medical Journal is indexed in ULAKBIM TR Index, Turkish Medline, DOAJ, Index Copernicus, EBSCO and Turkey Citation Index. Ahi Evran Medical Journal is periodical scientific publication. Can not be cited without reference. Responsibility of the articles belong to the authors.
