DOES SERUM BILIRUBIN LEVEL PROVIDE INFORMATION ABOUT MORTALITY IN THE EMERGENCY CLINIC ?

Abstract

Aims: As the elderly population grows, so does the number of geriatric patients admitted to emergency departments. This highlights the need for new, accessible markers to assess mortality. This study investigates serum bilirubin as a potential marker. Methods: This retrospective study included 240 patients over 65 years old who presented to a university hospital emergency department over 3 months. Patients with trauma, liver or biliary tract diseases, or using hepatotoxic drugs were excluded. Results: Of the patients, 178 survived and 62 died within 30 days. Significant differences were observed between the two groups in direct bilirubin, age, albumin, lactate, BUN, and creatinine levels (p < 0.05). Logistic regression analysis showed BUN and lactate as independent predictors of mortality. Conclusion: Bilirubin levels, in addition to established markers like BUN and lactate, may be helpful in evaluating mortality risk in geriatric patients presenting to emergency departments.

Keywords

• direct bilirubin
• creatinine
• emergency department
• geriatrics
• mortality

SERUM BİLİRUBİN DÜZEYİ ACİL SERVİSTE MORTALİTE HAKKINDA BİLGİ SAĞLAR MI ?

Abstract

Amaç: Yaşlı nüfusun artmasıyla birlikte acil servislere başvuran geriatrik hasta sayısı da artmaktadır. Bu durum, mortaliteyi değerlendirmede kullanılabilecek yeni ve erişilebilir belirteçlere olan ihtiyacı ortaya koymaktadır. Bu çalışmada serum bilirubinin potansiyel bir belirteç olarak değerlendirilmesi amaçlanmıştır. Yöntemler: Bu retrospektif çalışmaya, üç aylık süre içerisinde bir üniversite hastanesinin acil servisine başvuran 65 yaş ve üzeri 240 hasta dahil edilmiştir. Travma öyküsü olanlar, karaciğer veya safra yolu hastalığı bulunanlar ya da hepatotoksik ilaç kullanan hastalar çalışma dışı bırakılmıştır. Bulgular: Hastaların 178’i sağ kalmış, 62’si ise 30 gün içinde hayatını kaybetmiştir. Sağ kalanlar ile kaybedilen hastalar arasında direkt bilirubin, yaş, albümin, laktat, kan üre nitrojeni (BUN) ve kreatinin düzeyleri açısından anlamlı farklılık saptanmıştır (p < 0,05). Lojistik regresyon analizinde BUN ve laktat mortalitenin bağımsız belirleyicileri olarak bulunmuştur. Sonuç: BUN ve laktat gibi yerleşik belirteçlere ek olarak, bilirubin düzeyleri de acil servise başvuran geriatrik hastalarda mortalite riskinin değerlendirilmesinde yararlı olabilir.

Keywords

• direkt bilirubin
• kreatinin
• acil servis
• geriatri
• mortalite

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