Gastrointestinal Kanama ile Hastaneye Yatırılan Kritik Hastalarda Mortalite ile İlişkili Faktörler: Üniversite Hastanesinden Kesitsel Bir Çalışma

Öz

ÖZ Amaç: Bu çalışmanın amacı, yoğun bakım ünitesine (YBÜ) kabul edilen gastrointestinal (Gİ) kanamalı hastaların demografik özelliklerini, komorbiditelerini, temel laboratuvar verilerini ve mortaliteyi öngören parametreleri skorlama sistemlerini kullanarak belirlemektir. Gereç ve Yöntemler: Haziran 2019 ile Aralık 2023 tarihleri arasında Akdeniz Üniversitesi Hastanesi İç Hastalıkları YBÜ'nde takip edilen hastaların verileri retrospektif olarak incelendi. Hastaların YBÜ'ne kabulünden sonraki ilk 24 saat içinde ölçülen SOFA ve APACHE-II skorları kaydedildi. Kan ürünü replasman miktarları, laboratuvar sonuçları, laktat düzeyleri ve endoskopi verileri incelendi. Bu veriler hayatta kalan ve ölen hasta gruplarında karşılaştırıldı. Bulgular: Çalışmaya 95 hasta dahil edildi. Bu hastaların yoğun bakım takibi sonucunda mortalite oranı %29,47 olarak belirlendi. Hastaların INR ve laktat düzeylerinin hastane içi mortaliteyi öngörebileceği belirlendi. Artan laktat ve INR düzeyleri ölüm grubunda anlamlı olarak daha yüksekti (HR: 1,29; CI: 1,13-1,46 ve p<0,001, HR: 1,41; CI: 1,16-1,70 ve p<0,001). Sonuç: Laktat ve INR düzeyleri, Gİ kanama ile YBÜ'ye kabul edilen hastalarda mortalite tahmini için bağımsız risk faktörleridir ve hastaların YBÜ takibinde önemli olabilir. Anahtar Kelimeler: Yoğun bakım, Gastrointestinal kanama, Mortalite

Anahtar Kelimeler

• Yoğun bakım
• gastrointestinal kanama
• mortalite

Factors Related to Mortality in Critically Ill Patients Hospitalized with Gastrointestinal Hemorrhage: A Cross-sectional Study from a University Hospital

Abstract

Objective: This study aims to ascertain the demographic characteristics, comorbidities, fundamental laboratory data and mortality predictors of patients with gastrointestinal (GI) bleeding admitted to the intensive care unit (ICU) by the application of scoring methods. Material and Methods: Data of patients followed up in Akdeniz University Hospital Internal Medicine ICU between June 2019 and December 2023 were retrospectively reviewed. The Acute Physiology and Chronic Health Evaluation (APACHE)-II and Sequential Organ Failure Assessment (SOFA) scores of the patients were recorded within the initial 24 hours of ICU admission. The quantities of blood product replacements, laboratory findings, lactate concentrations, and endoscopic data were analyzed. The statistics were compared between the groups of survival and non-survival (deceased) patients. Results: The study included 95 patients. The mortality rate in these patients was determined as 29.47%. The international normalized ratio (INR) and lactate levels of patients were found to be predictive of in-hospital mortality. Lactate and INR levels were markedly elevated in the mortality group, with an hazard ratio (HR) of 1.29 (95% confidence interval [CI]: 1.13-1.46, p<0.001) and a HR of 1.41 (CI: 1 includes.16-1.70, p<0.001). Conclusion: Lactate and INR levels serve as independent risk indicators for mortality prediction in patients admitted to the ICU with GI bleeding and may be significant in the ICU follow-up of these patients. Key Words: Intensive care, Gastrointestinal bleeding, Mortality

Keywords

• Intensive care
• gastrointestinal bleeding
• mortality

Kaynakça

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