Klinik Tıp Aile Hekimliği

Abstract

Abstract

Introduction: Homocysteine is an
essential metabolite ofmethionine that can not be taken with the diet.
It is associated with serious diseases including moderate hyperhomocy
steinemia, coronary artery disease, stroke, alzheimer, schizophrenia and
spina bifida. Decubitis ulcers are a health problemthat increases
morbidity and mortality, cause to stay at the hos-pital for a long time
and increases the cost of  treatment. Itis a process that begins with a
decrease in tissue perfusion inthe body area where exposed to prolonged
pressure, and cango on until tissue death.In this study, the
relationship between homocysteine and phase of wound, atherosclerosis
and diabetes also the relationship between beddependent durationand
atherosclerosis and diabetes were examined.

Materials and Methods:
34 patients with decubitis ulcers who being treated at the palliative
care center at TheMinistry of Health Ordu University Education and
ResearchHospital were included in the study. Patients were classified
according to bed dependency period, phase of decubitisulcer,
homocysteine level, presence of atherosclerosis andpresence of diabetes
mellitus. One way variance analysis wasused to determine whether or not
there was a difference inbed dependency times and homocysteine levels
accordingto the phase of decubitis ulcer. Student t-test was used to
determine whether there was a difference in bed dependencytimes and
homocysteine levels according to the presence ofatherosclerosis and
diabetes mellitus. Whether or not there was a relationship between the
appearance of atherosclerosis and diabetes mellitus and the decubitis
ulcer phasewas determined by chi-square analysis. Bedside
dependencytimes and homocysteine levels were correlated with age
andhomocysteine levels were estimated by Pearson correlation
coefficient.

Findings:There was no significant difference
in the du-ration of bed dependence and homocysteine levels of the
pa-tients in terms of decubitis ulcer phase. However, it was observed
that homocysteine levels of patients with clinically3rd and 4th wound
stage were higher than patients with wound stage 2. In patients in
stages 3rd and 4th, mild homocysteine is elevated (values of 15-30 Mmol /
L). According tothe presence of atherosclerosis, there was no
significant difference between bed-residence time and homocysteine
levelsof the patients. According to diabetes, there was no significant
difference between bedresidence time and homocysteine levels of the
patients (P> 0,05). Furthermore, no relationship was found between
the decubitis ulcer progressionof patients and atherosclerosis and
diabetes mellitus. In addition, a statistically significant relationship
was not found between the age of the patient and homocysteine levels,
while a positive relationship was found between bed-dependencytimes and
homocysteine levels of the patients. Therefore, itwas observed that the
homocysteine levels increased as thebed dependency times of the patients
increased.

Conclusion: There is a need for studies involvingmore patients with subtopics such as the relationship between
homocysteine anddecubitis ulcers, and wound phaseassociated with
decubitis ulcer and the length of bed-dependency. It is thought that the
results of these studies may leadto new treatment approaches for
decubitis ulcer with highmorbidity and mortality.