Yoğun Bakım Ünitesinde Tedavi Edilen Yaşlı Hastaların D Vitamini Düzeylerinin Prognoz Üzerine Etkisi

Year 2020, , 13 - 17, 31.03.2020

Hülya Yiğit Özay , İbrahim Mungan , Güneş Çobanoğlu Ercan Sema Turan , Banu Eler Çevik

https://doi.org/10.16899/jcm.705176

Abstract

Giriş ve Amaç: Dünyada yaşlı nüfusun %50-60’ında vitamin D eksikliği vardır. Kritik hastalarda ise vitamin D eksikliğinin (25(OH)D<20ng/ml) prevalansı %70’i aşmaktadır. Bu çalışmada Yoğun Bakım Ünitesi(YBÜ)’nde takip ve tedavi edilen 65 yaş üstü; vitamin D verilen ve verilmeyen hastaların prognoz açısından karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Kasım 2014-Nisan 2015 tarihleri arası hastanemiz YBÜ ’de takip ve tedavi edilen hastaların kayıtları geriye dönük olarak incelendi. Enteral beslenen ve vitamin D desteği alan 20 hasta (Grup D), enteral beslenen ancak vitamin D desteği almayan 20 hasta (Grup K) arasında yoğun bakıma kabul sırasında(T1), 7.(T2) ve 15.(T3) günlerde ölçülen vitamin D, albümin, prealbumin, total lenfosit, CRP düzeyleri ve triceps kas kalınlığı açısından fark olup olmadığı değerlendirildi.
Bulgular: İki grup demografik veriler açısından benzerdi. Grup D ile Grup K arasında T1,T2 ve T3 zamanlarında vitamin D düzeyleri, albümin- prealbümin düzeyleri, enfeksiyon oranları, mekanik ventilasyon süreleri, yoğun bakım yatış günü ve mortalite açısından istatistiksel olarak anlamlı bir fark saptanmazken T1 ve T2 zamanında total lenfosit(TLS) düzeyleri(p<0,05) vitamin D grubunda istatistiksel olarak anlamlı yüksek idi. Hastaların sadece T3 zamanında vitamin D ve diğer değişkenler ele alındığında ise APACHE II değerleri, MV gün, T3 albümin, T3 prealbümin ve T3 total proteinle istatistiki olarak anlamlı ilişki gözlendi.
Sonuç: Çalışmamızda vitamin D verilen grupla verilmeyen grup arasında bazı değişkenlerde anlamlı fark gözlenmesi, prospektif ve daha fazla sayıda hasta ile yapılacak çalışmalar açısından yol gösterici olacağını düşünmekteyiz.

Keywords

Vitamin D, yaşlı hasta, yoğun bakım

The effect of vitamin-d levels on prognosis of elderly patients treated in intensive care unit

Abstract

Background : 50-60% of elderly population in the world has vitamin D deficiency. In critically ill patients, the prevalence of vitamin D deficiency (25 (OH) D <20 ng / ml) exceeds 70%. The aim of this study was to compare the prognosis of patients over 65 years of age with and without vitamin D supplementation in the Intensive Care Unit (ICU).
Materials and Methods: The records of patients who were followed-up and treated in our hospital between November 2014 and April 2015 were retrospectively reviewed. The patients were grouped as enteral-fed with vitamin D supplementation (20 patients, Group D) and enterally fed without vitamin D supplementation (20 patients, Group K). Vitamin D, albumin, prealbumin, total lymphocyte, CRP levels and triceps muscle thickness were measured during the admission to intensive care unit (T1), on days 7 (T2) and 15 (T3).
Results: The two groups were similar in terms of demographic data. There was no statistically significant difference between Group D and Group K in terms of vitamin D levels, albumin-prealbumin levels, infection rates, duration of mechanical ventilation, intensive care unit stay and mortality in T1, T2 and T3 times, while total lymphocyte levels (p <0,05) in T1 and T2 were statistically significant in vitamin D group. When vitamin D and other variables were evaluated at time T3, a statistically significant relationship was observed with APACHE II values, MV day, T3 albumin, T3 prealbumin and T3 total protein.
Conclusion: In our study, a significant difference was observed between the vitamin D supplementation group and the group which was not given. In our opinion, the result of this study will be a guide to prospective randomized trials involving more patients.

Keywords

Vitamin D, elderly patient, intensive care unit

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