Acil Servise Solunum Semptomlarıyla Başvuran 65 Yaş ve Üzeri Hastalarda Mortaliteyi Öngören Klinik ve Laboratuvar Bulgular
Yıl 2026,
Cilt: 6 Sayı: 1, 6 - 11, 19.01.2026
Ekrem Taha Sert
,
Kamil Kokulu
,
Hüseyin Mutlu
,
Mustafa Önder Gönen
,
Betül Çiğdem Yortanlı
,
Emin Hüseyin Akar
,
Oğuz Yürük
Öz
Amaç: Bu çalışma, acil servise (AS) solunum semptomları ile başvuran 65 yaş ve üzeri hastaların klinik ve laboratuvar özellikleri ile birlikte, hastane içi mortaliteyi etkileyen faktörleri değerlendirmeyi amaçlamıştır.
Gereç ve Yöntem: Bu retrospektif çalışmaya, 1 Ocak 2020 ile 1 Ocak 2025 tarihleri arasında acil servise solunum semptomları ile başvuran 65 yaş ve üzeri hastalar dahil edilmiştir. Hastalar iki yaş grubuna (65–74 ve ≥75) ayrılmış, demografik, klinik ve laboratuvar verileri toplanmıştır. Hastane içi mortalitenin bağımsız prediktörleri lojistik regresyon analizleri ile belirlenmiştir.
Bulgular: Solunum semptomları ile başvuran 65 yaş ve üzeri toplam 597 hasta çalışmaya dahil edilmiştir. Bunların 476’sı (%79.7) 65–74 yaş arasında, 121’i (%20,3) ise ≥75 yaş grubundadır. Hastane içi mortalite oranı %5.7 olarak belirlenmiştir. Çok değişkenli analizde, yaş ≥75 yıl (odds oranı [OR]: 2.01, %95 güven aralığı [GA]: 1.44–3.10, p < 0,001), kanser varlığı (OR: 1.96, %95 GA: 1.33–4.18, p = 0.045), troponin pozitifliği (OR: 2,35, %95 GA: 1.45–5.66, p = 0.026) ve yüksek laktat seviyesi (OR: 3.21, %95 GA: 1.71–4.20, p = 0.007) hastane içi mortalitenin bağımsız belirleyicileri olarak saptanmıştır.
Sonuç: İleri yaş, kanser varlığı, troponin pozitifliği ve yüksek laktat düzeyleri, solunum semptomlarıyla AS’ye başvuran yaşlı hastalarda hastane içi mortalitenin önemli bağımsız belirleyicileridir. Bu yüksek riskli hastaların erken teşhisi ve uygun tedavisi, klinik sonuçları iyileştirmek için önemlidir.
Etik Beyan
Bu çalışma protokolü Aksaray Üniversitesi Sağlık Bilimleri Bilimsel Araştırma Etik Kurulu tarafından 2025/12 protokol numarası ile onaylanmıştır.
Destekleyen Kurum
Yazarlar bu çalışmanın herhangi bir finansal destek almadığını beyan etmişlerdir
Teşekkür
Yazarlar bu çalışmaya katılan tüm katılımcılara teşekkürlerini sunarlar.
Kaynakça
-
Mahmood MN, Dhakal SP. Ageing population and society: a scientometric analysis. Qual Quant. 2023; 57:3133-3150
-
Değerli V, Korkmaz T. Characteristics and outcomes in elderly patients with dyspnea arriving by ambulance at the emergency department of a tertiary hospital. Turkish Journal of Geriatrics. 2020; 23(3):362-373.
-
Sert ET, Kokulu K. Performance of the PATHOS score in predicting in-hospital mortality in patients aged 65 years and older admitted to the intensive care unit from the emergency department. Cukurova Med J. 2025;50(1):99–105.
-
Benedict MOA, Adefuye AO. Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa. Pan Afr Med J. 2020; 36:245.
-
Delerme S, Ray P. Acute respiratory failure in the elderly: diagnosis and prognosis. Age and Ageing. 2008; 37: 251–257.
-
Šteinmiller J, Routasalo P, Suominen T. Older people in the emergency department: a literature review. Int J Older People Nurs. 2015;10(4):284-305.
-
Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; (185): 435-452.
-
Kelly AM, Keijzers G, Klim S, et al. An observational study of dyspnea in emergency departments: the Asia, Australia, and New Zealand dyspnea in emergency departments study (AANZDEM). Acad Emerg Med. 2017; 24:328–336.
-
Shiber JR, Santana J. Dyspnea. Med Clin North Am. 2006;(90):453-479.
-
Wilber ST, Gerson LW. A research agenda for geriatric emergency medicine. Acad Emerg Med. 2003;(10): 251-260.
-
Dundar ZD, Ayranci MK. Presenting Symptoms of Older Emergency Department Patients: A Single- Center Experience of 10,692 Patients in Turkey. Acta Clin Belg. 2020; 75:405-410
-
Kelly AM, Holdgate A, Keijzers G, et al. Epidemiology, prehospital care and outcomes of patients arriving byambulance with dyspnoea: an observational study. Scand J Trauma Resusc Emerg Med. 2016; 24:113
-
Ray P, Birolleau S, Lefort Y, et al. Acute respiratory failure in the elderly: Etiology, emergency diagnosis and prognosis. Critical Care. 2006; 10(3): R82.
-
Sim YS, Jung H, Shin TR, et al. Mortality and outcomes in very elderly patients 90 years of age or older admitted to the ICU. Respir Care. 2015; 60(3): 347–355.
-
Soares M, Carvalho MS, Salluh JI, et al. Effect of age on survival of critically ill patients with cancer. Crit Care Med. 2006; 34(3): 715–721.
-
Vosylius S, Sipylaite J, Ivaskevicius J. Determinants of outcome in elderly patients admitted to the intensive care unit. Age Ageing. 2005; 34(2): 157–162.
-
Lee YL, Ha SO, Park YS, et al. Baseline and clinical characteristics of older adults admitted to the intensive care unit through the emergency room: Analysis based on age groups. HKJEM. 2021;28(2): 85-92.
Clinical and Laboratory Predictors of Mortality in Patients Aged 65 and Older Presenting with Respiratory Symptoms to the Emergency Department
Yıl 2026,
Cilt: 6 Sayı: 1, 6 - 11, 19.01.2026
Ekrem Taha Sert
,
Kamil Kokulu
,
Hüseyin Mutlu
,
Mustafa Önder Gönen
,
Betül Çiğdem Yortanlı
,
Emin Hüseyin Akar
,
Oğuz Yürük
Öz
Puspose: This study aimed to evaluate the clinical and laboratory characteristics, as well as factors influencing in-hospital mortality, in patients aged 65 years and older who presented to the emergency department (ED) with respiratory symptoms.
Material and Method: This retrospective study included patients aged 65 years and older who presented to the ED with respiratory symptoms between January 1, 2020, and January 1, 2025. Patients were categorized into two age groups (65–74 and ≥75), and demographic, clinical, and laboratory data were collected. Independent predictors of in-hospital mortality were identified using logistic regression analyses.
Results: A total of 597 patients aged ≥65 years presenting with respiratory symptoms were included. Among them, 476 (79.7%) were aged 65–74 years and 121 (20.3%) were ≥75 years. In-hospital mortality was 5.7%.Multivariate analysis identified age ≥75 years (odds ratio [OR]: 2.01, 95% confidence interval [CI]: 1.44–3.10, p < 0.001), cancer (OR: 1.96, 95% CI: 1.33–4.18, p = 0.045), troponin positivity (OR: 2.35, 95% CI: 1.45–5.66, p = 0.026), and elevated lactate level (OR: 3.21, 95% CI: 1.71–4.20, p = 0.007) as independent predictors of in-hospital mortality.
Conclusion: Advanced age, presence of cancer, troponin positivity, and elevated lactate levels are significant independent predictors of in-hospital mortality among elderly patients presenting with respiratory symptoms to the ED. Early identification and appropriate management of these high-risk patients are important to improve clinical outcomes.
Etik Beyan
This study protocol was approved by of Aksaray University Health Sciences Scientific Research Ethics Committee with a protocol number of 2025/12.
Destekleyen Kurum
The authors declared that this study has received no financial support
Teşekkür
The authors thank all the participants in this study.
Kaynakça
-
Mahmood MN, Dhakal SP. Ageing population and society: a scientometric analysis. Qual Quant. 2023; 57:3133-3150
-
Değerli V, Korkmaz T. Characteristics and outcomes in elderly patients with dyspnea arriving by ambulance at the emergency department of a tertiary hospital. Turkish Journal of Geriatrics. 2020; 23(3):362-373.
-
Sert ET, Kokulu K. Performance of the PATHOS score in predicting in-hospital mortality in patients aged 65 years and older admitted to the intensive care unit from the emergency department. Cukurova Med J. 2025;50(1):99–105.
-
Benedict MOA, Adefuye AO. Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa. Pan Afr Med J. 2020; 36:245.
-
Delerme S, Ray P. Acute respiratory failure in the elderly: diagnosis and prognosis. Age and Ageing. 2008; 37: 251–257.
-
Šteinmiller J, Routasalo P, Suominen T. Older people in the emergency department: a literature review. Int J Older People Nurs. 2015;10(4):284-305.
-
Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; (185): 435-452.
-
Kelly AM, Keijzers G, Klim S, et al. An observational study of dyspnea in emergency departments: the Asia, Australia, and New Zealand dyspnea in emergency departments study (AANZDEM). Acad Emerg Med. 2017; 24:328–336.
-
Shiber JR, Santana J. Dyspnea. Med Clin North Am. 2006;(90):453-479.
-
Wilber ST, Gerson LW. A research agenda for geriatric emergency medicine. Acad Emerg Med. 2003;(10): 251-260.
-
Dundar ZD, Ayranci MK. Presenting Symptoms of Older Emergency Department Patients: A Single- Center Experience of 10,692 Patients in Turkey. Acta Clin Belg. 2020; 75:405-410
-
Kelly AM, Holdgate A, Keijzers G, et al. Epidemiology, prehospital care and outcomes of patients arriving byambulance with dyspnoea: an observational study. Scand J Trauma Resusc Emerg Med. 2016; 24:113
-
Ray P, Birolleau S, Lefort Y, et al. Acute respiratory failure in the elderly: Etiology, emergency diagnosis and prognosis. Critical Care. 2006; 10(3): R82.
-
Sim YS, Jung H, Shin TR, et al. Mortality and outcomes in very elderly patients 90 years of age or older admitted to the ICU. Respir Care. 2015; 60(3): 347–355.
-
Soares M, Carvalho MS, Salluh JI, et al. Effect of age on survival of critically ill patients with cancer. Crit Care Med. 2006; 34(3): 715–721.
-
Vosylius S, Sipylaite J, Ivaskevicius J. Determinants of outcome in elderly patients admitted to the intensive care unit. Age Ageing. 2005; 34(2): 157–162.
-
Lee YL, Ha SO, Park YS, et al. Baseline and clinical characteristics of older adults admitted to the intensive care unit through the emergency room: Analysis based on age groups. HKJEM. 2021;28(2): 85-92.