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Yoğun Bakım Ünitesinde Takip Edilen Kafa ve Göğüs Travması Hastalarında Mortalite Oranı Tahmin Edilebilir mi?

Yıl 2021, Cilt: 5 Sayı: 2, 230 - 238, 29.05.2021
https://doi.org/10.46237/amusbfd.852002

Öz

Amaç: Bu çalışmanın amacı, kafa ve göğüs travması tanısıyla yoğun bakım ünitesinde takip edilen hastaların; revize travma skoru, basitleştirilmiş akut fizyoloji skoru ve çeşitli biyokimya parametrelerini araştırmak ve bu değerlerin mortalite oranı üzerindeki tahmin ettirme gücünü araştırmaktır.
Yöntem: Çalışmamız, üniversite hastanesi yoğun bakım ünitesinde (YBÜ) takip edilen kafa ve göğüs travma hastalarını, hastane veri tabanına dayanarak retrospektif olarak inceleyen gözlemsel kohort çalışmadır. Haziran 2016 ile Haziran 2017 yılları arasında üçüncü basamak bir hastanenin YBÜ’nde ardışık olarak tedavi edilen kafa ve göğüs travması hastalarının verileri kaydedildi. Hastalar mortalite ve yaşayan olarak iki gruba ayrıldı. Hastaların demografik verileri, basitleştirilmiş akut fizyoloji skoru (SAPS II) ve revize travma skoru (RTS), mekanik ventilasyonda ve yoğun bakım ünitesinde kalış süreleri, mortalite oranları, giriş Glaskow koma skoru (GKS), izlem süresince hemodiyaliz gereksinimleri, yoğun bakıma kabulden sonraki ilk 48 saat içinde beslenme durumu ve yoğun bakıma ilk kabul edildiklerindeki çeşitli biyokimya parametreleri değerlendirildi.
Bulgular: Çalışmamızda kafa ve göğüs travması hastalarında, hemodiyaliz tedavisi yapılan (p=0,0016), entübe edilen, mekanik ventilatörde takip edilen (p<0.001) ve parenteral olarak beslenen hastalarda, 28 günlük mortalite oranları daha yüksek bulundu. Hastaların yirmi sekiz günlük mortalite oranları, basitleştirilmiş akut fizyoloji skoru (SAPS II) (p<0.001), YBÜ'de kalma süresi (p=0.009), mekanik ventilasyon süresi (p<0.001) yüksek olanlarda ve serum kreatinin ve glikoz değerleri artmış olanlarda yüksek bulundu. 28 günlük mortalite oranı yüksek olan hastalarda, GKS, RTS ve serum albümin seviyesi anlamlı olarak düşük bulundu.
Sonuç: Kafa ve göğüs travma hastalarının mortalite oranlarını tahmin etmek için, RTS, GKS ve serum albumin seviyelerinin iyi bir belirteç olabileceğini düşünüyoruz.  

Kaynakça

  • 1. World Health Organization. Injuries and Violence the Facts. (2014). https://apps.who.int/iris/bitstream/handle/10665/44288/9789241599375_eng.pdf;jsessionid=7AC6A8CF40D4E0ACE9092C0E8B3AC29A?sequence=1 (Erişim Tarihi: 22.02.2021).
  • 2. Adıyaman, E., Tokur, M. E., Bal, Z. M., Gökmen, A. N., Koca, U. (2020). Retrospective Analysis of Trauma Patients Who were Treated and Followed inIntensive Care Unit. J Turk Soc Intensive Care, 17(3),146-153
  • 3. Gönültaş, F., Kutlutürk, K., Gok, A. F. K., Barut, B., Sahin, T. T., Yilmaz, S. (2020). Analysis of risk factors of mortality in abdominal trauma. Ulus Travma Acil Cerrahi Derg, 26(1),43-49.
  • 4. Bayır, A., Ak, A. (2004) An evaluation of the relationship between blood glucose level and prognosis in acute phase of head injuries. Ulus Travma Acil Cerrahi Derg, 10(3),192-195.
  • 5. Tintinalli, J. E., Stapczynski, J. S., Ma, O. J., Cline, D. M., Cydulka, R. K., Meckler, G. D. (1996). Emergency medicine: a comprehensive study guide (4th ed.). New York; McGraw-Hill.
  • 6. Emircan, Ş., Özgüç, H., Aydın, Ş., Özdemir., F, Köksal., Ö, Bulut., M. (2011). Factors Affecting Mortality in Patients With Thorax Trauma. Ulusal Travma Acil Cerrahi Derg, 17(4),329-33.
  • 7. Hefny, A. F., Idris, K., Eid, H. O., Abu-Zidan, F. M. (2013). Factors Affecting Mortality of Critical Care Trauma Patients. African Health Sciences, (13),731-5.
  • 8. Haddad, S. H., Yousef, Z. M., Al-Azzam, S. S., AlDawood, A. S., Al-Zahrani, A. A., AlZamel, H. A., et al. (2015). Profile, Outcome and Predictors of Mortality of Abdomino- Pelvic Trauma Patients in A Tertiary Intensive Care Unit in Saudi Arabia. Injury, (46), 94-9.
  • 9. Champion, H. R., Copes, W. S., Sacco, W. J., Lawnick, M. M., Keast, S. L., Bain, L. W. Jr., et al. (1990). The Major Trauma Outcome Study: Establishing Natinol Norms for Care. J Trauma, (30),1356-6.
  • 10. Kim, S. C., Kim, D. H., Kim, T. Y., Kang, C., Lee, S. H., Jeong, J. H., et al. (2017). The Revised Trauma Score Plus Serum Albumin Level Improves The Prediction of Mortality in Trauma Patients. American Journal of Emergency Medicine, (35),1882–1886
  • 11. Akkoca, M., Tokgöz, S., Yılmaz, K. B., Güler, S., Akıncı, M., Balas, S., et al. (2018). Mortality Determiners for Fall From Height Cases. Ulusal Travma Acil Cerrahi Derg, 24(5),445-449
  • 12. MacLeod, J. B., Lynn, M., McKenney, M. G., Cohn, S. M., Murtha, M. (2003). Early Coagulopathy Predicts Mortality in Trauma. J Trauma, 55(1),39-44.
  • 13. Godinjak, A., Iglica, A., Rama, A., Tančica, I., Jusufović, S., Ajanović, A., et al. (2016). Predictive Value of SAPS II and APACHE II Scoring Systems for Patient Outcome in a Medical Intensive Care Unit. Acta Med Acad, 45(2),97-103
  • 14. Park, S. K., Chun, H. J., Kim, D. W., Im, T. H., Hong, H. J., Yi, H. J. (2009). Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in Predicting Hospital Mortality of Neurosurgical Intensive Care Unit Patients. J Korean Med Sci, 24(3),420-6.
  • 15. Jennet, B., Bond, M. (1975). Assessment of Outcome After Severe Brain Damage. Lancet, (1), 480-4.
  • 16. Çete, Y., Pekdemir, M., Oktay, C., Eray, O., Bozan, H., Ersoy, F. (2001). The Role of Computed Tomography for Minor Head Injury. Ulusal Travma Acil Cerrahi Derg, 7(3),184-194.
  • 17. Grenrot, C., Norberg, K. A., Hakansson, S. (1986). Intensive Care of The Elderly--A Retrospective Study. Acta Anaesthesiol Scand, (30),703-8.
  • 18. Kara, İ., Altınsoy, S., Gök, U. (2015) Bir Numune Hastanesi Genel Yoğun Bakım Ünitesinde Travma Hastalarının Mortalite Analizi. Turk J Intense Care, (13),68- 74.
  • 19. Kreymann, K .G., Berger, M. M., Deutz, N. E., Hiesmayr, M., Jolliet, P., Kazandjiev, G., et al. (2006). ESPEN Guidelines on Enteral Nutrition: Intensive Care. Clin Nutr, (25),210-23
  • 20. VanderBerghe, G., Vousters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., et al. (2001). Intensive Insulin Therapy in Critically Ill Patients. N Engl J Med, (345),1359-67.
  • 21. Laird, A. M., Miller, P. R., Kilgo, P. D., Meredith, J. W., Chang, M. C. (2004). Relationship of Early Hyperglycemia to Mortality in Trauma Patients. J Trauma, 56 (5),1058-62.
  • 22. Aquirre Puig, P., Orallo Moran, M. A., Pereira Matalobos, D., Prieto Requeijo, P. (2014). Current Role of Albumin in Critical Care. Rev Esp Anestesiol Reanim, 61(9),497- 504.
  • 23. Goldwasser, P. and Feldman, J. (1997). Association of Serum Albumin and Mortality Risk. Journal of Clin Epidemiol, (50),693-703.
  • 24. Kellum, J. A.(2015). Diagnostic Criteria for Acute Kidney Injury: Present and Future. Crit Care Clin, 31(4),621-32.
  • 25. Lai, W. H., Rau, C. S., Wu, S. C., Chen, Y. C., Kuo, H. Y. (2016). Post-Traumatic Acute Kidney Injury: A Cross-Sectional Study of Trauma Patients. Scand Resusc Emerg Med, 22,24(1),136.

Can Mortality Rate in Head and Chest Trauma Patients in the Intensive Care Unit be Predicted?

Yıl 2021, Cilt: 5 Sayı: 2, 230 - 238, 29.05.2021
https://doi.org/10.46237/amusbfd.852002

Öz

Objective: The aim of this study is to evaluate the patients who are followed up with a diagnosis of head and chest trauma; to investigate the revised trauma score, the simplified acute physiology score, and various biochemistry parameters and to reveal the role of these values on mortality rates.
Methods: Our study is an observational cohort study that retrospectively examines head, and thoracic trauma patients followed in the university hospital ICU, based on the hospital database. Data of trauma patients who were treated consecutively in the ICU of a tertiary hospital between June 2016 and June 2017 were recorded. Patients were divided into two groups as mortality and living. Demographic data of the patients simplified acute physiology score (SAPS II) and revised trauma score (RTS), length of stay in mechanical ventilation and intensive care unit, mortality rates, admission Glasgow coma score (GCS), hemodialysis requirements during follow-up, first post-ICU admission Nutritional status and various biochemistry parameters admitted to intensive care unit were evaluated within 48 hours.
Results: In our study, 28-day mortality rates were found to be higher in patients with head and chest trauma, those who underwent hemodialysis treatment (p = 0.0016), were intubated, followed by mechanical ventilation (p <0.001), and fed parenterally. Patients with 28-day mortality rates, simplified acute physiology score (SAPS) 2 (p <0.001), length of stay in the ICU (p = 0.009), high mechanical ventilation duration (p <0.001), and those with increased serum creatinine and glucose levels found high. In patients with a high 28-day mortality rate, GCS, RTS, and serum albumin levels were found to be significantly lower.
Conclusion: We think that RTS, GCS, and serum albumin levels may be useful markers to estimate the mortality rates of head and chest trauma patients.

Kaynakça

  • 1. World Health Organization. Injuries and Violence the Facts. (2014). https://apps.who.int/iris/bitstream/handle/10665/44288/9789241599375_eng.pdf;jsessionid=7AC6A8CF40D4E0ACE9092C0E8B3AC29A?sequence=1 (Erişim Tarihi: 22.02.2021).
  • 2. Adıyaman, E., Tokur, M. E., Bal, Z. M., Gökmen, A. N., Koca, U. (2020). Retrospective Analysis of Trauma Patients Who were Treated and Followed inIntensive Care Unit. J Turk Soc Intensive Care, 17(3),146-153
  • 3. Gönültaş, F., Kutlutürk, K., Gok, A. F. K., Barut, B., Sahin, T. T., Yilmaz, S. (2020). Analysis of risk factors of mortality in abdominal trauma. Ulus Travma Acil Cerrahi Derg, 26(1),43-49.
  • 4. Bayır, A., Ak, A. (2004) An evaluation of the relationship between blood glucose level and prognosis in acute phase of head injuries. Ulus Travma Acil Cerrahi Derg, 10(3),192-195.
  • 5. Tintinalli, J. E., Stapczynski, J. S., Ma, O. J., Cline, D. M., Cydulka, R. K., Meckler, G. D. (1996). Emergency medicine: a comprehensive study guide (4th ed.). New York; McGraw-Hill.
  • 6. Emircan, Ş., Özgüç, H., Aydın, Ş., Özdemir., F, Köksal., Ö, Bulut., M. (2011). Factors Affecting Mortality in Patients With Thorax Trauma. Ulusal Travma Acil Cerrahi Derg, 17(4),329-33.
  • 7. Hefny, A. F., Idris, K., Eid, H. O., Abu-Zidan, F. M. (2013). Factors Affecting Mortality of Critical Care Trauma Patients. African Health Sciences, (13),731-5.
  • 8. Haddad, S. H., Yousef, Z. M., Al-Azzam, S. S., AlDawood, A. S., Al-Zahrani, A. A., AlZamel, H. A., et al. (2015). Profile, Outcome and Predictors of Mortality of Abdomino- Pelvic Trauma Patients in A Tertiary Intensive Care Unit in Saudi Arabia. Injury, (46), 94-9.
  • 9. Champion, H. R., Copes, W. S., Sacco, W. J., Lawnick, M. M., Keast, S. L., Bain, L. W. Jr., et al. (1990). The Major Trauma Outcome Study: Establishing Natinol Norms for Care. J Trauma, (30),1356-6.
  • 10. Kim, S. C., Kim, D. H., Kim, T. Y., Kang, C., Lee, S. H., Jeong, J. H., et al. (2017). The Revised Trauma Score Plus Serum Albumin Level Improves The Prediction of Mortality in Trauma Patients. American Journal of Emergency Medicine, (35),1882–1886
  • 11. Akkoca, M., Tokgöz, S., Yılmaz, K. B., Güler, S., Akıncı, M., Balas, S., et al. (2018). Mortality Determiners for Fall From Height Cases. Ulusal Travma Acil Cerrahi Derg, 24(5),445-449
  • 12. MacLeod, J. B., Lynn, M., McKenney, M. G., Cohn, S. M., Murtha, M. (2003). Early Coagulopathy Predicts Mortality in Trauma. J Trauma, 55(1),39-44.
  • 13. Godinjak, A., Iglica, A., Rama, A., Tančica, I., Jusufović, S., Ajanović, A., et al. (2016). Predictive Value of SAPS II and APACHE II Scoring Systems for Patient Outcome in a Medical Intensive Care Unit. Acta Med Acad, 45(2),97-103
  • 14. Park, S. K., Chun, H. J., Kim, D. W., Im, T. H., Hong, H. J., Yi, H. J. (2009). Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in Predicting Hospital Mortality of Neurosurgical Intensive Care Unit Patients. J Korean Med Sci, 24(3),420-6.
  • 15. Jennet, B., Bond, M. (1975). Assessment of Outcome After Severe Brain Damage. Lancet, (1), 480-4.
  • 16. Çete, Y., Pekdemir, M., Oktay, C., Eray, O., Bozan, H., Ersoy, F. (2001). The Role of Computed Tomography for Minor Head Injury. Ulusal Travma Acil Cerrahi Derg, 7(3),184-194.
  • 17. Grenrot, C., Norberg, K. A., Hakansson, S. (1986). Intensive Care of The Elderly--A Retrospective Study. Acta Anaesthesiol Scand, (30),703-8.
  • 18. Kara, İ., Altınsoy, S., Gök, U. (2015) Bir Numune Hastanesi Genel Yoğun Bakım Ünitesinde Travma Hastalarının Mortalite Analizi. Turk J Intense Care, (13),68- 74.
  • 19. Kreymann, K .G., Berger, M. M., Deutz, N. E., Hiesmayr, M., Jolliet, P., Kazandjiev, G., et al. (2006). ESPEN Guidelines on Enteral Nutrition: Intensive Care. Clin Nutr, (25),210-23
  • 20. VanderBerghe, G., Vousters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., et al. (2001). Intensive Insulin Therapy in Critically Ill Patients. N Engl J Med, (345),1359-67.
  • 21. Laird, A. M., Miller, P. R., Kilgo, P. D., Meredith, J. W., Chang, M. C. (2004). Relationship of Early Hyperglycemia to Mortality in Trauma Patients. J Trauma, 56 (5),1058-62.
  • 22. Aquirre Puig, P., Orallo Moran, M. A., Pereira Matalobos, D., Prieto Requeijo, P. (2014). Current Role of Albumin in Critical Care. Rev Esp Anestesiol Reanim, 61(9),497- 504.
  • 23. Goldwasser, P. and Feldman, J. (1997). Association of Serum Albumin and Mortality Risk. Journal of Clin Epidemiol, (50),693-703.
  • 24. Kellum, J. A.(2015). Diagnostic Criteria for Acute Kidney Injury: Present and Future. Crit Care Clin, 31(4),621-32.
  • 25. Lai, W. H., Rau, C. S., Wu, S. C., Chen, Y. C., Kuo, H. Y. (2016). Post-Traumatic Acute Kidney Injury: A Cross-Sectional Study of Trauma Patients. Scand Resusc Emerg Med, 22,24(1),136.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Özlem Öner 0000-0001-6171-2114

Emel Yıldız 0000-0003-4493-2099

Murat Emre Tokur 0000-0002-3957-4971

Necati Gökmen 0000-0002-3225-7666

Yayımlanma Tarihi 29 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 5 Sayı: 2

Kaynak Göster

APA Öner, Ö., Yıldız, E., Tokur, M. E., Gökmen, N. (2021). Can Mortality Rate in Head and Chest Trauma Patients in the Intensive Care Unit be Predicted?. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 5(2), 230-238. https://doi.org/10.46237/amusbfd.852002