Acil Servise Solunum Semptomlarıyla Başvuran 65 Yaş ve Üzeri Hastalarda Mortaliteyi Öngören Klinik ve Laboratuvar Bulgular

Öz

Amaç: Bu çalışma, acil servise (AS) solunum semptomları ile başvuran 65 yaş ve üzeri hastaların klinik ve laboratuvar özellikleri ile birlikte, hastane içi mortaliteyi etkileyen faktörleri değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Bu retrospektif çalışmaya, 1 Ocak 2020 ile 1 Ocak 2025 tarihleri arasında acil servise solunum semptomları ile başvuran 65 yaş ve üzeri hastalar dahil edilmiştir. Hastalar iki yaş grubuna (65–74 ve ≥75) ayrılmış, demografik, klinik ve laboratuvar verileri toplanmıştır. Hastane içi mortalitenin bağımsız prediktörleri lojistik regresyon analizleri ile belirlenmiştir. Bulgular: Solunum semptomları ile başvuran 65 yaş ve üzeri toplam 597 hasta çalışmaya dahil edilmiştir. Bunların 476’sı (%79.7) 65–74 yaş arasında, 121’i (%20,3) ise ≥75 yaş grubundadır. Hastane içi mortalite oranı %5.7 olarak belirlenmiştir. Çok değişkenli analizde, yaş ≥75 yıl (odds oranı [OR]: 2.01, %95 güven aralığı [GA]: 1.44–3.10, p < 0,001), kanser varlığı (OR: 1.96, %95 GA: 1.33–4.18, p = 0.045), troponin pozitifliği (OR: 2,35, %95 GA: 1.45–5.66, p = 0.026) ve yüksek laktat seviyesi (OR: 3.21, %95 GA: 1.71–4.20, p = 0.007) hastane içi mortalitenin bağımsız belirleyicileri olarak saptanmıştır. Sonuç: İleri yaş, kanser varlığı, troponin pozitifliği ve yüksek laktat düzeyleri, solunum semptomlarıyla AS’ye başvuran yaşlı hastalarda hastane içi mortalitenin önemli bağımsız belirleyicileridir. Bu yüksek riskli hastaların erken teşhisi ve uygun tedavisi, klinik sonuçları iyileştirmek için önemlidir.

Anahtar Kelimeler

• Acil servis
• solunum semptomları
• yaşlılık
• mortalite

Clinical and Laboratory Predictors of Mortality in Patients Aged 65 and Older Presenting with Respiratory Symptoms to the Emergency Department

Abstract

Puspose: This study aimed to evaluate the clinical and laboratory characteristics, as well as factors influencing in-hospital mortality, in patients aged 65 years and older who presented to the emergency department (ED) with respiratory symptoms. Material and Method: This retrospective study included patients aged 65 years and older who presented to the ED with respiratory symptoms between January 1, 2020, and January 1, 2025. Patients were categorized into two age groups (65–74 and ≥75), and demographic, clinical, and laboratory data were collected. Independent predictors of in-hospital mortality were identified using logistic regression analyses. Results: A total of 597 patients aged ≥65 years presenting with respiratory symptoms were included. Among them, 476 (79.7%) were aged 65–74 years and 121 (20.3%) were ≥75 years. In-hospital mortality was 5.7%.Multivariate analysis identified age ≥75 years (odds ratio [OR]: 2.01, 95% confidence interval [CI]: 1.44–3.10, p < 0.001), cancer (OR: 1.96, 95% CI: 1.33–4.18, p = 0.045), troponin positivity (OR: 2.35, 95% CI: 1.45–5.66, p = 0.026), and elevated lactate level (OR: 3.21, 95% CI: 1.71–4.20, p = 0.007) as independent predictors of in-hospital mortality. Conclusion: Advanced age, presence of cancer, troponin positivity, and elevated lactate levels are significant independent predictors of in-hospital mortality among elderly patients presenting with respiratory symptoms to the ED. Early identification and appropriate management of these high-risk patients are important to improve clinical outcomes.

Keywords

• Emergency department
• respiratory symptoms
• aged
• mortality

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