Yoğun Bakıma Yatan Sistemik Otoimmün Hastalıkları olan Hastaların Geriye Dönük İncelenmesi

Year 2022, Volume: 44 Issue: 3, 360 - 366, 14.03.2022

Ebru Karakoç , İlkay Ceylan , Meryem Onay , Birgül Yelken

https://doi.org/10.20515/otd.1007882

Abstract

Sistemik otoimmün hastalıklar, yoğun bakım ünitesine kabul gerektiren hayatı tehdit eden komplikasyonlara neden olabilir. Bu komplikayonların erken tanınması hasta sonuçlarını iyileştirebilir. Bu çalışmanın amacı yoğun bakım ünitesine yatan sistemik otoimmün hastalığıolan hastaları değerlendirimek ve sonuçlara etki eden faktörleri belirlemektir. Yöntem: 2010-2020 yılları arasında 3 basamak genel yoğun bakıma yatırılan sistemik otoimmün hastalıkları olan 18 yaş üstü hastalar geriye dönük olarak incelendi. Demografik bilgileri, APACHE 2 ve SOFA skorları, yoğun bakıma yatış nedenleri, primer hastalıklarına yönelik aldıkları tedaviler, yoğun bakımda uygulanan tedaviler ve sağ kalım oranları kayıt edildi. 67 erişkin hasta çalışmaya dahil edildi. Başlıca yatış nedenlerinin enfeksiyon (n:35), olduğu görüldü. 43 hasta yoğun bakımda kaybedildi. Yoğun bakım yatışı sırasında mekanik ventilasyon ihtiyacı olması ve yatış kültürlerinde mantar üremesi olması mortalite ile ilişkilii bulunmuştur. Ek olarak yüksek hastalık skorlarınn varlığı mortalite ile ilişkilli bulunmuştur. Yoğun bakım ünitesine yatış gerektiren sistemik otoimmün hastalıkların ölüm oranı yüksektir. Ölümlerin büyük çoğunluğu immünsüpresyona bağlı enfeksiyon nedeniyle olmaktadır. Bu yönde uygulanacak tedbirler ve eğitimler ile bu ölümlerin önüne geçilebilir.

Keywords

vaskulitler, yoğun bakım, mortalite, sistemik otoimmün hastalıklar

Retrospective Evaluation of Patients with Systemic Autoimmune Diseases Admitted to Intensive Care

Abstract

Introduction: Systemic autoimmune diseases can cause life-threatening complications that require admission to the intensive care unit. Early recognition of these complications can improve patient outcomes. The aim of this study is to evaluate patients with systemic autoimmune diseases hospitalized in the intensive care unit and identify the factors affecting the patient outcomes.
Methods: Patients (aged > 18) with systemic autoimmune diseases who were hospitalized in a tertiary general intensive care unit between 2010 and 2020 were retrospectively analyzed. Demographic data, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, reasons for admission to the intensive care unit, information on treatments for primary diseases and those administered in the intensive care unit, and survival rates were recorded.
Results: The study included 67 adult patients. The main reason for hospitalization was infection (n = 35), and 43 patients died in the intensive care unit. The need for mechanical ventilation during intensive care hospitalization and the presence of fungal infection as per fungal cultures performed at hospitalization were found to be associated with mortality. In addition, the presence of high disease severity scores was associated with mortality.
Conclusion: The mortality rate of patients with systemic autoimmune diseases requiring intensive care unit admission was found to be high. The majority of deaths occurred as a result of infections associated with immunosuppression. Such deaths can be prevented by implementing specific measures and conducting training targeting these issues.

Keywords

: Vasculitis, mortality, intensive care unit, systemic autoimmune diseases

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