İnmede mortalite ve ilişkili risk faktörleri: Türkiye, Gaziantep’ten tek merkezli kohort çalışma

Öz

Amaç: Çoğu durumda diyabet akut inme sonucunu kötüleştirir. Akut hiperglisemi, yüksek CRP ve fibrinojen seviyeleri hastane içi mortalite riskinde artışın bir prediktörüdür. Ancak, pnömoni inme hastalarının en sık ölüm nedeni olarak görülmektedir. Bu çalışmada iskemik inmede mortalite için risk faktörlerini tanımlamayı amaçladık. 

Yöntemler: Bu çalışma yoğun bakım ünitesinde (YBÜ) tedavi görmüş inme hastalarının retrospektif olarak toplanan verilerinin bir analizidir. 

Bulgular: Yüz yirmi sekiz hastanın dosyası değerlendirildi. Mortalite oranı % 30,4 idi (n = 39). YBÜ'deki yan etkiler, pnömoni bulgularının varlığı, trans-trakeal entübasyon, uzun YBÜ'de kalma süresi mortalite ile ilişkiliydi. Yüksek nabız, düşük SPO2 ve pH seviyeleri de mortalite ile ilişkiliydi. Yüksek kan şekeri ve fibrinojen seviyeleri, yüksek CRP seviyeleri ve CRP varyasyonu mortalite ile ilişkili bulundu. Yüksek APACHI-II, A2DS2 skorları ve düşük GKS skorları mortalite ile ilişkili bulundu. Pnömoni YBÜ'deki en sık görülen advers olaydı ve ikinci en fazla ölüm nedeni oldu. 

Sonuç: APACHI-II, A2DS2 skorları ve düşük GKS skorları mortaliteyi öngörebilir, pnömoniyi önlemek iskemik inmenin akut mortalite oranını azaltabilir. CRP, iskemik inme hastalarında fibrinojen düzeyleri ile birlikte prognostik faktörler içinde yer alması gerektiğini düşünmekteyiz.

Anahtar Kelimeler

• İnme,Mortalite,C-reaktif protein,Fibrinojen

Evaluation of stroke mortality and related risk factors: A single-center cohort study from Gaziantep, Turkey

Abstract

Aim: In most cases diabetes worsens the outcome of acute stroke. Acute hyperglycemia, higher C-reactive protein (CRP) and fibrinogen levels predict increased risk of in-hospital mortality. However, pneumonia is found to be major causes of death after stroke. In this study we aimed to define the risk factors of mortality of ischemic stroke.

Methods: This study was an analysis of retrospectively collected data of patients treated in intensive care unit (ICU) due to ischemic stroke.

Results: One hundred twenty-eight patients’ files were evaluated. Mortality rate was 30.4% (n=39). The risk of stroke death was higher in presence of adverse events in ICU, presence of pneumonia findings, trans-tracheal intubation, long ICU stay, higher heart beats, lower SPO2 and pH levels, higher blood glucose and fibrinogen levels, higher CRP levels and the variation of CRP, higher APACHI-II, A2DS2 (risk of stroke) scores and lower GCS scores. Pneumonia was the most adverse event in ICU and the second most reason of the death.

Conclusions: APACHI-II, A2DS2 scores and GCS scores can predict the stroke death, and preventing the pneumonia may decrease acute mortality rate of ischemic stroke. CRP together with fibrinogen levels can be used as a prognostic factor in ischemic stroke.

Keywords

• Stroke,Mortality,C-reactive protein,Fibrinogen

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