Travmatik ve Non-Travmatik Kardiyopulmoner Arrest Hastaların Kıyaslanması

Abstract

Amaç: Bu çalışmada, acil servise travmatik ve non-travmatik nedenlerle kardiyopulmoner arrest olarak kabul edilen hastaların demografik özelliklerinin, laboratuvar bulgularının ve klinik süreçlerinin değerlendirilerek mortalite ile ilişkili faktörlerin belirlenmesi amaçlandı.
Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmaya üçüncü basamak bir acil servise kardiyopulmoner arrest ön tanısı ile kabul edilen hastalar dahil edildi. Hastalar arrest etiyolojisine göre travmatik ve non-travmatik nedenli olarak sınıflandırıldı. Demografik veriler, başvuru zamanı, arrest etiyolojisi, yoğun bakım yatış durumu, laboratuvar parametreleri (arteriyel kan gazı pH değeri ve serum laktat düzeyi) ile acil serviste bekleme süreleri hastane otomasyon sistemi üzerinden elde edildi.
Bulgular: Çalışmaya toplam 434 hasta dahil edildi. Hastaların 342’si (%78,8) acil serviste ölürken, 92’si (%21,2) yoğun bakıma yatırıldı. Ölen hastaların yaş ortalaması sağ kalan hastalara göre anlamlı derecede daha yüksek bulundu (p=0,033). Yoğun bakım mortalitesi %76,1 olarak saptandı. Ölen hastalarda başvuru anında ölçülen kan pH değerinin anlamlı derecede düşük (p=0,016) ve laktat düzeyinin anlamlı derecede yüksek olduğu (p=0,011) gözlendi. Arrest etiyolojisinin travmatik veya non-travmatik olması ile mortalite arasında istatistiksel olarak anlamlı ilişki saptanmadı (p>0,05). Yoğun bakıma yatan hastalarda kabul anında alınan kan pH ve laktat düzeylerinde medikal ve travmatik grup arasında anlamlı fark olmadığı görüldü (p>0,05).
Sonuç: Acil servise kardiyopulmoner arrest nedeniyle kabul edilen hastalarda ileri yaş, düşük pH ve yüksek laktat düzeyleri mortalite ile ilişkili önemli prognostik faktörlerdir. Arrest etiyolojisinin travmatik veya non-travmatik olması mortalite üzerinde istatistiksel olarak anlamlı bir fark göstermemiştir.

Keywords

• acil servis
• kardiyopumoner arrest
• travma

Comparison of Traumatic and Non-Traumatic Cardiopulmonary Arrest Patients

Abstract

Aim: This study aimed to evaluate the demographic characteristics, laboratory findings, and clinical processes of patients admitted to the emergency department with cardiopulmonary arrest due to traumatic and non-traumatic causes, and to identify factors associated with mortality.
Materials and Methods: In this retrospective, single-center study, patients admitted to a tertiary emergency department with a preliminary diagnosis of cardiopulmonary arrest were included. Patients were classified into traumatic and non- traumatic groups according to the etiology of arrest. Demographic data, time of admission, arrest etiology, intensive care unit admission status, laboratory parameters (arterial blood gas pH value and serum lactate level), and length of stay were obtained from the hospital automation system.
Results: A total of 434 patients were included in the study. Of these, 342 patients (78.8%) died in emergency department, while 92 patients (21.2%) were admitted to the intensive care unit. The mean age of non-survivors was significantly higher than that of survivors (p=0.033). Intensıve care unit mortality was found to be 76.1%. In patients who died, admission blood pH values were significantly lower (p=0.016), and lactate levels were significantly higher (p=0.011). No statistically significant association was found between mortality and arrest etiology (traumatic vs. non-traumatic) (p>0.05). No significant differences were observed in arterial blood pH and lactate levels at admission between medical and traumatic patients admitted to the intensive care unit (p>0.05).
Conclusion: Advanced age, low arterial pH, and elevated lactate levels were identified as important prognostic factors associated with mortality in patients admitted to the emergency department with cardiopulmonary arrest. Whether the etiology of the cardiopulmonary arrest was traumatic or non-traumatic did not show a statistically significant difference in mortality.

Keywords

• cardiopulmonary arrest
• emergency department
• trauma

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