Yoğun Bakım Ünitesinde Uygulanan Sürekli Renal Replasman Tedavisinin Mortalite üzerine Etkisi: Retrospektif Analiz

Öz

Amaç: Bu çalışmada yoğun bakım ünitemizde sürekli renal replasman tedavisi (SRRT) uygulanan hastaların demografik verilerini, klinik tanılarını ve mortaliteyi öngörmede etkili olabilecek labora-tuvar değerlerini ve skorlama sistemlerini retrospektif olarak değerlendirmeyi amaçladık. Materyal ve Metod: Üçüncü basamak yoğun bakım ünitemizde SRRT uygulanan hastaların verileri retrospektif olarak incelendi. Yoğun Bakım Üniteleri‘ne ait dijital arşiv verileri, hastaların doktor anamnezi, laboratuvar sonuçları ve hemşire gözlem formları incelendi. Hastalara dört zaman dili-minde (yoğun bakım yatışında, SRRT öncesinde, SRRT sonrası ve taburculuk) Acute Physiology and Chronic Health Evaluation II (APACHE II), Glaskow Koma skoru (GKS), Sequential Organ Failure As-sessment (SOFA), Crp/Albümin oranı incelenip, mortaliteye olan etkileri karşılaştırıldı. Bulgular: Çalışmamıza 2017-2022 yılları arasında toplam 107 hasta dahil edildi ve bu olguların 101’i mortalite ile sonuçlanmıştır. SRRT öncesine göre SRRT sonrası CRP/Albümin değerlerinde ve GKS skorlarında değişim anlamlı bulunmamış (p>0,05), ancak APACHE II (p<0,01), ve SOFA (p<0,01) skorla-rındaki düşüşün ise mortaliteyi öngörmede anlamlı bulunmuştur. Mortaliteye göre olguların cinsiye-ti ve vücut kitle indeksi ölçümleri, inotropik ajan kullanımı, yoğun bakımda yatış süresi, hastanede kalış süresi ve ek hastalık açısından anlamlı fark bulunmadı (p>0,05). Ancak yaşın mortalite açısından risk faktörü olduğu saptandı (p<0,01). Sonuç: SRRT yoğun bakım hastalarında birçok altta yatan sebep nedeniyle uygulanmakta, APACHE II ve SOFA skorlarını iyileştirebilmekle beraber; CRP/Albümin değerinin SRRT işleminin mortalite üzerindeki etkisini öngörmede istatiksel olarak anlamlı bir ilişki bulunamamıştır.

Anahtar Kelimeler

• Sürekli renal replasman tedavisi
• akut böbrek hasarı
• yoğun bakım

Effect of Continuous Renal Replacement Therapy on Mortality in the Intensive Care Unit: A Retrospective Analysis

Öz

Background: In this study, we aimed to retrospectively evaluate the demographic data, clinical diagnoses, laboratory values and scoring systems that may be effective in predicting mortality in patients undergoing continuous renal replacement therapy (CRRT) in our intensive care unit. Materials and Methods: The data of patients who underwent CRRT in our tertiary intensive care unit were retrospectively analyzed. Digital archive data of Intensive Care Units, patients' medical history, laboratory results and nurse observation forms were analyzed. Acute Physiology and Chronic Health Evaluation II (APACHE II), Glasgow Coma score (GCS), Sequential Organ Failure Assessment (SOFA), Crp/Albumin ratio were analyzed at four time points (during ICU admission, before CRRT, after CRRT and discharge) and their effects on mortality were compared. Results: A total of 107 patients were included in our study between 2017 and 2022 and 101 of these cases resulted in mortality. The change in CRP/Albumin values and GCS scores after CRRT compared to before CRRT was not significant (p>0.05), but the decrease in APACHE II (p<0.01) and SOFA (p<0.01) scores were found to be significant in predicting mortality. No significant difference was found in terms of gender and body mass index measurements, use of inotropic agents, length of intensive care unit stay, length of hospital stay and comorbidities (p>0.05). However, age was found to be a risk factor for mortality (p<0.01). Conclusion: Although CRRT is performed in intensive care unit patients for many underlying causes and can improve APACHE II and SOFA scores, no statistically significant relationship was found be-tween CRP/Albumin ratio in predicting the effect of CRRT on mortality

Anahtar Kelimeler

• Continuous renal replacement therapy
• acute kidney injury
• intensive care unit

Kaynakça

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