Genel Cerrahi Hastalarında Postoperatif Deliryum Erken Tanısı

Öz

ÖZ Giriş/Amaç: Postoperatif deliryum (POD) sık görülen bir postoperatif komplikasyondur. Bu çalışmada öncelikle Genel Cerrahi uygulanan hastalarda POD tanısının erken konulması amaçlanmıştır. Gereç ve Yöntem: Mart 2018-Mayıs 2018 tarihleri arasında Genel Cerrahi Kliniği tarafından ameliyat edilen ve genel anestezi uygulanan 18 yaş ve üzeri 303 hastanın verileri çalışmaya dahil edildi. Hastaların demografik verileri, mesleği, eğitim durumu, gelir düzeyi, ek hastalıkları, ASA (Amerikan Anestezi Derneği) skoru, geçirilmiş ameliyatları, psikiyatrik veya nörolojik hastalık öyküsü, alkol, sigara veya uyuşturucu madde kullanım öyküsü ve hafıza sorunları sorgulandı. kaydedildi. Hastaların ameliyat öncesi mental düzeylerini belirlemek için Mini Mental Durum Muayenesi (MMSE) kullanıldı. Hastanın teşhisi, adı, yapılacak ameliyatın süresi ve özellikleri, ameliyatın acil veya elektif olup olmadığı, kullanılan ilaçlar, kateterizasyon tipi kaydedilir. Hastalarda POD tanısı Konfüzyon Değerlendirme Yöntemi (CAM) ile değerlendirildi. Bulgular: Hastaların %2-6'sında (8 hasta) POD gelişti. Sonuçlar, hastaların eğitim düzeyi arttıkça deliryum riskinin azaldığını gösterdi. Kullanılan anestezik ajanlar arasında deliryum ile sadece midazolam arasında anlamlı ilişki saptanmıştır. Sonuç: Postoperatif erken dönemde CAM ile POD tanısı koymak avantajlıydı. POD hastalarının tedavi planlaması erken dönemde yapılabilmektedir. Bu sayede POD tanısının atlanması sonucu mortalite, morbidite ve maliyet artışının önüne geçilmiştir. Anahtar Kelimeler: Postoperatif Deliryum, Genel Cerrahi, Bilişsel Bozukluklar

Anahtar Kelimeler

• Postoperative Delirium
• General Surgery
• Cognitive Disorders

Early Diagnosis Of Postoperative Delirium in Patients Who Underwent General Surgery

Abstract

ABSTRACT Objective: Postoperative delirium (POD) is a common postoperative complication. This study aimed to diagnose POD early primarily in patients who underwent General Surgery. Material and Method: Data of 303 patients at the age of 18 and above who were operated by General Surgery Clinic between March 2018 and May 2018,who received general anesthesia were included in the study. Patients’ demographic data, occupation, educational status, income level, additional diseases, ASA (American Society of Anesthesia) score, previous surgeries, history of a psychiatric or neurological disease, history of alcohol, cigarette, or drug use, and memory problems were recorded. Mini Mental State Examination (MMSE) was used to identify preoperative mental levels of the patients. Diagnosis of the patient, name, duration and features of the surgery to be performed, whether the surgery was urgent or elective, drugs used, type of catheterization recorded. The diagnosis of POD in patients was evaluated with Confusion Assessment Method (CAM). Results: POD developed in 2-6% (8 patients) of the patients. Results showed that the risk of delirium decreased as the education levels of the patients increased. A significant relationship was recorded between delirium and only midazolam among anesthetic agents used. Conclusion: Diagnosing POD with CAM in an early postoperative period was advantageous. The treatment planning of the patients for POD could be done in the early period. By doing this, increase in mortality, morbidity and cost as a result of missing the diagnosis of POD was prevented. Key Words: Postoperative Delirium, General Surgery, Cognitive Disorders

Keywords

• Postoperative Delirium
• General Surgery
• Cognitive Disorders

Kaynakça

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