TY  - JOUR
T1  - Postoperatif pulmoner komplikasyonları öngörmede yaşam kalitesinin önemi
TT  - The role of health quality in predicting postoperative pulmonary complications
AU  - Gülşen, Aşkın
PY  - 2019
DA  - September
DO  - 10.19161/etd.607475
JF  - Ege Tıp Dergisi
JO  - EJM
PB  - Ege Üniversitesi
WT  - DergiPark
SN  - 1016-9113
SP  - 229
EP  - 238
VL  - 58
IS  - 3
LA  - tr
AB  - Amaç: Abdominalcerrahilerde postoperatif pulmoner komplikasyonlar (PPK), morbitide vemortalitenin önemli bir nedenidir. Ayrıca hastanede yatış süresini uzatanönemli bir faktördür.Preoperatif değerlendirme,komplikasyonların tahmin edilmesinde ve önlem alınmasında önemli bir yeroluşturmaktadır. Değerlendirme sıklıkla öykü, fizik muayene, akciğer grafisi,solunum fonksiyon testleri, gerekli olgularda arteriyel kan gazı, ve egzersiztestleri ile yapılmaktadır. Bu çalışmada, diğer değerlendirme parametrelerindenfarklı olarak PPK’ı öngörmede yaşam kalitesinin önemini araştırmayı amaçladık.Yöntem:ÇalışmamızaGenel Cerrahi AD’da elektif batın cerrahisi yapılacak olan 124 hastaalınmıştır. Hastalar ameliyat öncesi 1 haftalık dönemde değerlendirilmiş venottingham sağlık profili (NSP) skoru hesaplanmıştır. Postoperatif 48.saatsonrasında semptomlar ve komplikasyonlar incelenerek, preoperatif NSP değerleriile karşılaştırılmıştır.Bulgular PPK görülenhastalarda NSP-total puanı ort. 125,71 ± 114,09 puan vegörülmeyenlerde ort. 63,65 ± 72,75 puandı(p=0.002). Fiziksel mobilite, ağrı, enerji düzeyi, duygusal reaksiyon, uykudurumu, ve sosyal izolasyon düzeylerine göre yapılan değerlendirmede emosyoneldurum haricinde diğer tüm puanlar komplikasyon görülen hastalarda daha yükseksaptandı. Mortalite görülen hastaların ort. 209,31 ± 130,74 puan olduğu görüldü. Hastalar NSP puanlarına göre grup-1 (0-49,9), grup-2(50,0-99,9), grup-3 (100-149,9) ve grup-4 (>150 puan) olaraksınıflandırıldı. Buna göre grup-4 olan hastalarda %72,7 pulmonerkomplikasyon görüldü (p<0.001). Yine 150 puan ve üzeri olan hastalardasolunumsal komplikasyonlar 7,6 kat, solunum dışı komplikasyonlar ise 6,7 katartmış bulundu.Sonuç: Çalışmamız,hastaların NSP puanı 150 ve üzerinde olması durumunda komplikasyonların dahafazla olduğunu göstermiştir. Ayrıca NSP sağ kalımı da iyi predikte etmiştir. Busonuçlar ile NSP’nin preoperatif risk değerlendirmede yararlı olabileceğidüşünülmüştür.
KW  - Elektif batın cerrahisi
KW  - nottingham sağlık profili
KW  - postoperatif pulmoner komplikasyonlar
KW  - yaşam kalitesi
N2  - Aim: Postoperative pulmonarycomplications (PPC) in abdominal surgeons is an important factor that prolongsthe hospitalization period as well as is an important cause of morbidity andmortality. Preoperative evaluation is an important part of estimatingcomplications and taking precautions. However, pulmonary function tests,arterial blood gases, and exercise tests are used in the evaluation. In thisstudy, we aimed to investigate the importance of quality of life in predictingPPC different from other evaluation parameters.Patientsand Methods: 124 patients who were assigned for various elective abdominal proceduresin department of surgery; were included in the study. Notthingham healthprofile (NHP) scores 1 week prior to the surgery were calculated for eachpatient and were compared to the pulmonary complications (PPC) that evolved inthe postoperative 48th hour.Results:Inpatients with PPC mean NHP score was 125,71 + 114,09 and in patientswithout PPC the score was found to be 63,5+72,75. Thedifference among the groups was statistically significant. The patients weredistributed in to 4 groups according to their score and in group 4 (>150)pulmonary complication rate was 72,7% (p<0.001).Patients were classified according to their NHP scores as group-1 (0-49,9),group-2 (50,0-99,9), group-3 (100-149,9) and group-4 (150 points).Furthermore; in group-4;pulmonary complication frequency was 7,6 times greater than the others.Conclusion:In thepresent study it is found that patients with a NHP score greater than 150encountered complications more frequently. Therefore; it can be assumed thatNHP scoring system can be used in preoperative evaluation and postoperativerisk prediction.
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UR  - https://doi.org/10.19161/etd.607475
L1  - https://dergipark.org.tr/tr/download/article-file/788116
ER  -