Does admission from different sources have any influence on intensive care unit outcome in COPD patients?

AYDOĞDU, MÜGE; GÜRSEL, Gül

Does admission from different sources have any influence on intensive care unit outcome in COPD patients?

Müge AYDOĞDU, (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Yoğun Bakım Ünitesi, Ankara, Türkiye)

Gül GÜRSEL (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Yoğun Bakım Ünitesi, Ankara, Türkiye)

Tüberküloz ve Toraks

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Yıl: 2008 Cilt: 56 Sayı: 4 Sayfa Aralığı: 375 - 381 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Does admission from different sources have any influence on intensive care unit outcome in COPD patients?

Öz:

Bu çalışmanın amacı; yoğun bakım ünitesi (YBÜ)’nde takip edilen kronik obstrüktif akciğer hastalığı (KOAH) olan hastaların bu üniteye gelmeden önce takip edildikleri bölümlerin ve bu bölümlerle ilgili faktörlerin hastaların prognozunu nasıl etkilediğini araştırmaktır. Retrospektif, gözlemsel kohort çalışması. Hastaların demografik özellikleri, hastalıklarının ve hava yolu obstrüksiyonlarının ağırlığı, komorbiditeleri, hangi bölümlerden YBÜ’ye kabul edildikleri [göğüs hastalıkları servisi (GHS), acil servis (AS)], entübasyon öncesi ve sonrası dönemde noninvaziv mekanik ventilasyon (NIMV) kullanımları ve kan gazları kaydedildi. İstatistiksel analiz olarak t-test, ki-kare testi ve lojistik regresyon analizi kullanıldı. Çalışmaya YBÜ’de takip edilen, 52’si GHS’den, 52’si AS’dan kabul edilen toplam 104 KOAH’lı hasta alındı. İki grup karşılaştırıldığında yaş, cinsiyet, komorbidite, hava yolu obstrüksiyonunun ağırlığı ve yatış “Acute Physiology Assessment and Chronic Health Evaluation (APACHE)-II” skoru açısından anlamlı farklılık bulunmadı. AS’dan kabul edilen hastalar daha hipoksemikti ve daha sık toplum kökenli pnömoni ile başvurmuşlardı; GHS’den kabul edilen hastalarda ise daha sık entübasyon öncesi ve sonrası dönemde NIMV kullanımı (p< 0.001) ve daha yüksek HCO-3 değerleri mevcuttu. Potansiyel risk faktörlerinden yüksek APACHE-II skoru ve mekanik ventilasyon süresi mortalite için bağımsız risk faktörleri olarak saptandı. KOAH’lı hastaların bazı yatış yeri özellikleri anlamlı farklılık göstermesine rağmen GHS’den veya AS’dan kabul edilmeleri prognozlarını ve YBÜ sonuçlarını olumsuz etkilememektedir.

Anahtar Kelime: Zaman faktörleri Hasta kabulü Kohort çalışmaları Solunum, yapay Kan gazı analizi Yoğun bakım Hastalık ciddiyet indeksi Acil servis, hastane Yatış süresi Tedavi sonucu Sağkalım oranı Akciğer hastalığı, kronik obstrüktif APACHE Yoğun bakım üniteleri Geriyedönük çalışma

Konular: Solunum Sistemi Kulak, Burun, Boğaz

KOAH’lı hastaların farklı servislerden kabul edilmeleri yoğun bakım ünitesi sonuçlarını etkiler mi?

Öz:

Influence of admission source and admission source related factors on intensive care unit (ICU) outcome have not known much in patients with chronic obstructive pulmonary disease (COPD). The aim of the study was to investigate if admission source and related factors have any impact on ICU outcome in patients with COPD. A retrospective observational cohort study. Demographics of the patients, severity of admission disease and airflow limitation, comorbidity, source of admission [pulmonary ward (PW), emergency department (ED)], noninvasive mechanical ventilation (NIMV) therapies in the pre-and post-intubation period, and blood gases were recorded. T-test, chi-square test and logistic regression analysis were used for statistical analysis. One hundred and four patients were included in the study. Fifty two of them were admitted from PW and 52 from ED. There were no significant difference between age, gender, comorbidity, severity of airflow limitation and admission Acute Physiology Assessment and Chronic Health Evaluation (APACHE)-II scores among the patients admitted from PW and ED. While the patients admitted from ED were more hypoxemic, admitted with community acquired pneumonia more frequently, the patients admitted from PW, received NIMV trial in pre-intubation and post-extubation period more frequently (p< 0.001) and had higher HCO-3 levels. There was no significant difference in the ICU survival across the groups. Among these potential risk factors higher APACHE-II scores and duration of mechanical ventilation were independent risk factors for the mortality. These results suggest that while some of the admission characteristics were significantly different, admission from ED or PW did not have negative influence on ICU course and outcome in patients with COPD.

Anahtar Kelime: Pulmonary Disease, Chronic Obstructive APACHE Intensive Care Units Retrospective Studies Time Factors Patient Admission Cohort Studies Respiration, Artificial Blood Gas Analysis Intensive Care Severity of Illness Index Emergency Service, Hospital Length of Stay Treatment Outcome Survival Rate

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	AYDOĞDU M, GÜRSEL G (2008). Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. , 375 - 381.
Chicago	AYDOĞDU MÜGE,GÜRSEL Gül Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. (2008): 375 - 381.
MLA	AYDOĞDU MÜGE,GÜRSEL Gül Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. , 2008, ss.375 - 381.
AMA	AYDOĞDU M,GÜRSEL G Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. . 2008; 375 - 381.
Vancouver	AYDOĞDU M,GÜRSEL G Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. . 2008; 375 - 381.
IEEE	AYDOĞDU M,GÜRSEL G "Does admission from different sources have any influence on intensive care unit outcome in COPD patients?." , ss.375 - 381, 2008.
ISNAD	AYDOĞDU, MÜGE - GÜRSEL, Gül. "Does admission from different sources have any influence on intensive care unit outcome in COPD patients?". (2008), 375-381.

APA	AYDOĞDU M, GÜRSEL G (2008). Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. Tüberküloz ve Toraks, 56(4), 375 - 381.
Chicago	AYDOĞDU MÜGE,GÜRSEL Gül Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. Tüberküloz ve Toraks 56, no.4 (2008): 375 - 381.
MLA	AYDOĞDU MÜGE,GÜRSEL Gül Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. Tüberküloz ve Toraks, vol.56, no.4, 2008, ss.375 - 381.
AMA	AYDOĞDU M,GÜRSEL G Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. Tüberküloz ve Toraks. 2008; 56(4): 375 - 381.
Vancouver	AYDOĞDU M,GÜRSEL G Does admission from different sources have any influence on intensive care unit outcome in COPD patients?. Tüberküloz ve Toraks. 2008; 56(4): 375 - 381.
IEEE	AYDOĞDU M,GÜRSEL G "Does admission from different sources have any influence on intensive care unit outcome in COPD patients?." Tüberküloz ve Toraks, 56, ss.375 - 381, 2008.
ISNAD	AYDOĞDU, MÜGE - GÜRSEL, Gül. "Does admission from different sources have any influence on intensive care unit outcome in COPD patients?". Tüberküloz ve Toraks 56/4 (2008), 375-381.