Determination of Factors Affecting the Survival in Patients with Pulmonary Thromboembolism

Yıl 2019, Cilt: 16 Sayı: 3, 470 - 477, 25.12.2019

Sebih Alp Songül Özyurt Bilge Yılmaz Kara Dilek Karadoğan Neslihan Özçelik Aziz Gümüş Ünal Şahin

https://doi.org/10.35440/hutfd.525509

Cited By: 2

Öz

Objective: The
aim of this study was to investigate the factors affecting survival of the
patients hospitalized with pulmonary thromboembolism and complications that may
emerge at admission or during 6-months treatment period.

Material and Methods: The study was performed in patients who were
hospitalized and followed up with pulmonary embolism and were treated at the
Recep Tayyip Erdoğan University Faculty of Medicine Training and Research
Hospital Chest Diseases Clinic. Patients who were diagnosed with at least
segmental pulmonary artery filling defects between 01/01/2014 - 01/12/2016 over
20 years of age and spiral thorax angiography computed tomography were included
in the study.

 

Results: The
mean age of the patients was 73.04 ± 13.313 and 13 (26%) were male and 37 (74%)
were female. Pulse rate, modified Geneva and Wells scores, pulmonary embolism
severity index and simplified pulmonary embolism severity index scores were
higher in those who died than that of survivors. Both the RDW (Red Cell Distribution
With) and the 1st and 5th day MCV (Mean Corpusculer Volume) and hematocrit
levels were lower in those who died. While the number of platelets was higher
in patients who died, blood total protein and albumin levels were found to be
lower on the 1st and 5th days.  The
elevation of ALP (Alkaline phosphatase) on day 1, total bilirubin on day 5, and
CRP (C-Reactive Protein) elevation were associated with mortality.

 

Conclusion: High
levels of simplified pulmonary embolism severity index score, tachycardia,
hemoglobin, total protein, albumin levels, RDW level, ALP elevation, WBC, CRP
and total bilirubin levels on the 5th day were all associated with mortality.

Anahtar Kelimeler

: Pulmonary Thromboembolism, Mortality, 6-month follow-up

Pulmoner Tromboembolili Hastalarda Sağkalımı Etkileyen Faktörlerin Belirlenmesi

Öz

Amaç: Pulmoner tromboemboli tanısı ile yatırılarak tedavisi yapılan
hastalarda yatışında ve taburcu edildikten sonraki 6 ay boyunca devam eden
tedavi sürecinde ortaya çıkabilecek komplikasyonlar ve sağ kalımı etkileyen
faktörlerin araştırılması amaçlanmıştır.

Materyal ve
Metot: Çalışma Recep Tayyip
Erdoğan Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Göğüs
Hastalıkları Kliniğinde pulmoner emboli tanısı ile yatırılarak takip ve tedavi
edilen hastalarda yapıldı. 01/01/2014 - 01/12/2016 tarihleri arasında, spiral
toraks anjio bilgisayarlı tomografisinde en az segmental pulmoner arterde dolum
defekti saptanan erişkin hastalar çalışmaya alındı..

Bulgular: Çalışmaya alınan toplam 50 hastanın yaş ortalaması 73,04±13,313 yıl ve
13’ü (%26) erkek, 37’si (%74) kadındı. Eksitus olanlarda nabız, Modifiye Geneva
ve Wells skorları, pulmoner emboli şiddet indeksi ve basitleştirilmiş pulmoner emboli
şiddet indeksi skorları sağ kalanlara göre yüksekti. Eksitus olanlarda hem RDW
(Red Cell Distribution With) hem de 1. ve 5. Gün MCV (Mean Corpusculer Volum)
ve hematokrit düzeyleri daha düşüktü. Eksitus olanlarda platelet sayısı daha
yüksek iken 1. ve 5. gün kan total protein ve albümin düzeyleri düşük bulundu.
ALP (Alkalen fosfataz)’ın 1. günde yüksekliği, 5. günde total bilirubin ve CRP
(C-Reaktif Protein) yüksekliği mortalite ile ilişkili bulundu.

Sonuç: Çalışmamızda Basitleştirilmiş pulmoner emboli şiddet indeksi skorunun
yüksekliği, taşikardi, 1. gün ve 5. gün bakılan hemoglobin, total protein,
albümin düzeylerinin düşük olması, RDW düzeyi yüksekliği, ALP yüksekliği, 5.
Günde WBC, CRP ve total bilirubin düzeylerinin hala yüksek seyretmesi mortalite
ile ilişkili bulunmuştur.

Anahtar Kelimeler

Pulmoner Tromboembolizm, Sağkalım, 6 aylık izlem

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