Year 2019, Volume 1 , Issue 1, Pages 8 - 14 2019-11-01

Acil Servise Başvuran Malignite Hastalarının Morbidite ve Mortalitelerini Etkileyen Faktörler
Factors Affecting the Morbidity and Mortality of Malignancy Patients Admitted to the Emergency Department

Onur Tokocin [1] , Fatih Çakmak [2] , Afsin İpekci [3] , Deniz Necdet Tihan [4] , Didem Ceylan [5] , Mehmet Necmettin Sutasir [6] , Canturk Emir [7] , Ozgur Dandin [8] , Merve Tokocin [9] , Ibrahim Ikizceli [10]


Amaç: Çalışmada acil servis başvuran malignite hastalarının klinik karakteristik özelliklerini, morbidite ve mortalitelerine etki eden faktörleri inceleyerek hastaların bakım kalitesini ve hedefe yönelik hızlı tedavi bilincini artırmayı amaçladık. Gereç ve Yöntem: Üniversite Hastanesi Acil Tıp Kliniğine 06.11.2014-06.05.2015 tarihleri arasında başvuran, 18 yaş ve üzeri kanser hastaları prospektif olarak incelendi. Hastaların demografik özellikleri, vital bulguları, maligniteleri ile ilgili özellikler, yapılan tetkikler ve sonuçları, tedaviler ve acil serviste yatış süreleri değerlendirildi. Bulgular: Toplam 1283 hastanın, 1522 başvuru yaptığı tespit edildi. Hastaların %51,99'u erkek (ortalama yaş: 57,52±13,12), %48,01'i kadın (ortalama yaş: 69,05±15,15), genel yaş ortalaması 63,05±14,08 idi. Nefes darlığı (%17,94) en sık başvuru şikayeti olup, en sık rastlanan kanser türü akciğer kanseri (%16,23) idi. Erkeklerde en sık başvuru nedeni ateş, en sık kanser türü akciğer kanseri (%34,63); kadınlarda en sık başvuru şikayeti nefes darlığı, en sık kanser tipi meme kanseri olarak saptandı (%35,25). Hastaların %64'ünde uzak metastaz mevcuttu. Ortalama arteriyal basıncının, nabız dakika sayısının, hemoglobin düzeyinin, üremi ve hipoalbümineminin, mortalite ve yoğun bakım yatışı oranları üzerinde anlamlı etkisi saptandı. Hastaların %41,46'sı herhangi bir servise yatırılırken, %1,05'i kaybedildi. Hastaneye yatışı yapılan hastaların ortalama yatış süreleri 4,64±6,73 gün idi. Sonuç: Malignite hastaları acil servise başvuran hastaların önemli bir kısmını oluşturmaktadır. Acil servis hekimlerinin onkolojik aciller konusunda yeterli bilgi, deneyim ve tecrübe edinmeleri, bu hastaların mortalite ve morbidite oranlarını azaltacaktır. 

Objectives: The objective of this study is to identify the clinical characteristics and the factors affecting the morbidity and mortality of the patients with malignancy and to increase the quality of care and raise awareness of rapid targeted-therapy in the emergency department. Materials and Methods: In our study, cancer patients 18 years of age and older who presented to the emergency department of a university hospital were evaluated prospectively. Patients' demographics, vital signs, characteristics associated with malignancy, examinations performed, and their results, treatments, and length of stay were evaluated. Results: A total of 1283 patients and 1522 presentations were recorded. 51.99% of the patients were male, and 48.01% were female. The overall mean age was 63.05±14.08. The most prevalent symptom was dyspnea (17.94%), and the most common type of cancer was lung cancer (16.23%). In male patients, the most prevalent complaint was fever, and the most common type of cancer was lung cancer (34.63%). In female patients, the most prevalent complaint was dyspnea, and the most common type of cancer was breast cancer (35.25%). The influence of MAP, pulse, Hb levels, uremia, and hypoalbuminemia on mortality and ICU admission was significant. Overall, 41.46% of the patients were hospitalized, and 1.05% of the patients died. The average length of stay was 4.64±6.73 days.  Conclusion: Patients with malignancy constitute a significant portion of emergency department admissions. Promoting the emergency physicians' insight into and experience on oncological emergencies would contribute to decreasing the mortality and morbidity of these patients. 

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Primary Language en
Subjects Emergency Medicine
Journal Section Research Articles
Authors

Author: Onur Tokocin (Primary Author)
Country: Turkey


Author: Fatih Çakmak
Institution: İSTANBUL ÜNİVERSİTESİ - CERRAHPAŞA, CERRAHPAŞA TIP FAKÜLTESİ, HEKİMLİKTE ACİL VAKALAR ANABİLİM DALI
Country: Turkey


Author: Afsin İpekci
Institution: İSTANBUL ÜNİVERSİTESİ - CERRAHPAŞA, CERRAHPAŞA TIP FAKÜLTESİ, HEKİMLİKTE ACİL VAKALAR ANABİLİM DALI
Country: Turkey


Author: Deniz Necdet Tihan

Author: Didem Ceylan

Author: Mehmet Necmettin Sutasir

Author: Canturk Emir

Author: Ozgur Dandin

Author: Merve Tokocin

Author: Ibrahim Ikizceli
Institution: İSTANBUL ÜNİVERSİTESİ - CERRAHPAŞA, CERRAHPAŞA TIP FAKÜLTESİ, HEKİMLİKTE ACİL VAKALAR ANABİLİM DALI

Supporting Institution there is no
Dates

Application Date : September 13, 2019
Acceptance Date : September 21, 2019
Publication Date : November 1, 2019

AMA Tokocin O , Çakmak F , İpekci A , Tihan D , Ceylan D , Sutasir M , Emir C , Dandin O , Tokocin M , Ikizceli I . Factors Affecting the Morbidity and Mortality of Malignancy Patients Admitted to the Emergency Department. Phnx Med J.. 2019; 1(1): 8-14.