Kalp yetersizliği tedavi kılavuzlarına uymada kardiyologlar ile iç hastalıkları uzmanları arasındaki farklılıklar

Year 2005, Volume: 12 Issue: 1, 32 - 34, 03.04.2009

Ercan Varol Mehmet Özaydın Banu Köroğlu Abdullah Doğan Ahmet Altınbaş

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2005 Mart; 12(1)


Kalp yetersizliği tedavi kılavuzlarına uymada kardiyologlar ile iç hastalıkları uzmanları arasındaki farklılıklar


Ercan Varol , Mehmet Özaydın , Banu Kale Köroğlu, Abdullah Doğan, Ahmet Altınbaş



Özet

Günümüzde kronik kalp yetmezliğinin teşhis ve tedavisini ele alan çok sayıda kılavuz bulunmaktadır. Klinik uygulamada hangi düzeyde bu kılavuzlara uyulduğu ve bunun hasta prognozuna etkisi bilinmemektedir. Bu çalışma, bir devlet hastanesi düzeyinde kardiyolog ve iç hastalıkları uzmanlarının kalp yetmezliği kılavuzlarındaki önerileri ne ölçüde uyguladıklarını araştırmak amacıyla yapıldı. Isparta Devlet Hastanesi'nde kalp yetmezliği tanısıyla yatan 256 hastanın (Kardiyoloji Kliniğinde 148, İç Hastalıkları Kliniğinde108 hasta) tedavi protokolleri incelendi. Kardiyologlar anjiyotensin konverting enzim inhibitörlerini (ACEi ) (%79'a karşın %69, p<0.05) ve spironolakton'u (%57'e karşın %22, p<0.05) iç hastalıkları uzmanlarından daha fazla kullanmışlardı. Buna karşılık, iç hastalıkları uzmanları daha fazla aspirin kullanmışlardı (%45'e karşın %26, p<0.05). Bulgularımız, kalp yetmezliği kılavuzundaki tedavi protokollerine uyumun yetersiz olduğunu göstermektedir.



Anahtar kelimeler: Kalp yetmezliği, tedavi kılavuzları



Abstract



The differences between cardiologists and internal medicıine physicians in adherence to heart failure guidelines

There are now a number of guidelines outlining the diagnosis and management of patients with chronic heart failure. The extend to which these guidelines are used and the effects on patient outcomes are not well known. This study was done to examine the implementation of a heart failure guideline among cardiologist and internal medicine physicians in a state hospital setting. Treatment protocols of 256 patients (cardiology :148 patients and internal medicine: 108 patients) hospitalized for heart failure treatment in Isparta State Hospital were examined. Cardiologists had used more ACEi (%79 vs. %69, p<0.05) and spironolactone (%57 vs. %22, p<0.05) than internal medicine physicians. On the other hand internal medicine physicians had used more aspirin (%55 vs. %26, p<0.05) than cardiologists. Our findings has demonstrated that implementation of treatment protocols in heart failure guideline remains inadequade.



Key words: Heart failure, guidelines

Keywords

Kalp yetmezliði, tedavi kýlavuzlarý

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