Pulmoner Emboli Hastalarında Kan Basıncı İndeksinin Sağ Ventrikül Disfonksiyonu ve Mortalite ile Olan İlişkisi

Abstract

Amaç: Pulmoner emboli, acil servislerde sıkça karşılaşılan ve mortalitesi yüksek kardiyopulmoner bir acildir. Pulmoner emboli,  hastalarında mortaliteyi gösteren, sağ ventrikül disfonksiyonunun saptanmasında; Ekokardiyografinin (EKO) yapılması acil serviste her zaman hızlı ve kolay olmamaktadır. Bu çalışmadaki amaç; daha kolay elde edilebilen kan basıncı indeksinin, pulmoner emboli hastalarında sağ ventrikül disfonksiyonunun ve mortaliteyi belirlemedeki rolünü göstermektir. Gereç ve Yöntemler: Çalışmaya 2013- 2019 tarihleri arasında acil serviste bilgisayarlı tomografi pulmoner anjiografi sonucunda pulmoner emboli tanısı alan ve sonrasında EKO’su yapılan 180 hasta (90 kadın ve 90 erkek) çalışmaya dahil edildi. Kan basıncı indeksini; sistolik kan basıncının diyastolik kan basıncına bölünmesi ile elde edildi. Bulgular: Hastaların ortalama kan basıncı indeksini 1.7±0.2 olarak hesaplandı. EKO’da sağ ventrikül disfonksiyonu olan ve olmayan iki grup arasında kan basıncı indeksi yönünden istatistiksel olarak anlamlı farklılık saptanmadı (p=0.529). Hastaların %22.2’sinde 30 günlük mortalite gözlendi. Mortalite gözlenen ve gözlenmeyen grup arasında kan basıncı indeksi yönünden anlamlı fark yoktu (p=0.438). Sonuç: Pulmoner embolide kan basıncı indeksi ile sağ ventrikül disfonksiyonu ve mortalite arasında anlamlı bir ilişki tespit edilmedi. Ancak kan basıncı indeksi acil servislerde kolay ulaşılabilen ve uygulanabilen bir yöntem olması nedeniyle kullanılabilir bir parametre olduğunu düşünmekteyiz. Kan basıncı indeksi; özellikle sistolik kan basıncını düşüren pulmoner emboli hastalarında sağ ventrikül disfonksiyonunu ve mortaliteyi belirlemede daha doğru sonuçlar ortaya koyacağını tahmin etmekteyiz.

Keywords

• Pulmoner emboli
• kan basıncı indeksi
• moratalite

RELATIONSHIP BETWEEN BLOOD PRESSURE INDEX AND RIGHT VENTRICULAR DYSFUNCTION AND MORTALITY IN PATIENTS WITH PULMONARY EMBOLISM

Abstract

Objective:  Pulmonary embolism is a cardiopulmonary emergency commonly encountered in emergency departments with a high mortality rate. In cases of pulmonary embolism, the prompt and effortless implementation of echocardiography in the emergency department for the identification of right ventricular dysfunction, a significant predictor of mortality, is not always feasible. The aim of this study is to demonstrate the role of the readily available blood pressure index in determining right ventricular dysfunction and mortality in patients with pulmonary embolism. Material and Methods: A total of 180 patients (90 females and 90 males) who were diagnosed with pulmonary embolism based on computed tomography pulmonary angiography in the emergency department between 2013 and 2019 and subsequently underwent echocardiography were included in the study. The blood pressure index was obtained by dividing the systolic blood pressure by the diastolic blood pressure. Results: The average blood pressure index of the patients was calculated as 1.7±0.2. There was no statistically significant difference in terms of BPI between the two groups, one with right ventricular dysfunction and the other without right ventricular dysfunction, based on echocardiography (p=0.529). A total of 22.2% of the patients experienced 30-day mortality. There was no significant difference in terms of blood pressure index between the group with observed mortality and the group without observed mortality (p=0.438). Conclusion: No significant relationship was identified between blood pressure index and right ventricular dysfunction or mortality in patients with pulmonary embolism. However, considering the ease of accessibility and applicability of blood pressure index in emergency departments, we believe it can be considered as a useful parameter. We anticipate that blood pressure index would yield more accurate results in determining right ventricular dysfunction and mortality, especially in patients with pulmonary embolism who have reduced systolic blood pressure.

Keywords

• Pulmonary embolism
• blood pressure index
• mortality

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