Geriatrik sepsis hastalarında mortaliteyi öngörmede inflamatuar biyobelirteçlerin prognostik önemi

Yıl 2025, Cilt: 6 Sayı: 4, 371 - 376, 31.08.2025

Merve Bulun Yediyıldız , Kübra Taşkın , İrem Durmuş , Reyhan Fidan

https://doi.org/10.47582/jompac.1714806

Öz

Amaç:
Bu çalışmanın amacı, yoğun bakım ünitesinde (YBÜ) sepsis tanısı almış geriatrik hastalarda C-Reaktif Protein (CRP)/albümin oranı, Nötrofil/Lenfosit Oranı (NLR), Trombosit/Lenfosit Oranı (PLR) ve prokalsitonin (PCT) gibi inflamatuar biyobelirteçlerin mortaliteyi öngörmedeki prognostik değerini araştırmaktır.

Yöntemler:
Bu retrospektif çalışmada, Mayıs–Ekim 2023 tarihleri arasında YBÜ’de sepsis nedeniyle yatan 65 yaş ve üzeri 239 hastanın tıbbi kayıtları incelenmiştir. Demografik veriler, APACHE II skorları, laboratuvar biyobelirteçleri (CRP, prokalsitonin, tam kan sayımı), YBÜ kalış süresi ve mortalite verileri toplanmıştır. Mortalite ile ilişkili değişkenleri belirlemek için univaryant ve multivaryant lojistik regresyon analizleri uygulanmıştır.

Bulgular:
Genel mortalite oranı %66,9 olarak bulunmuştur. CRP, CRP/albümin oranı, Ortalama Trombosit Hacmi (MPV), Eritrosit Dağılım Genişliği (RDW), laktat düzeyi ve APACHE II skorları mortalite grubunda anlamlı derecede yüksek bulunmuştur (p<0,05). Multivaryant analizde yalnızca CRP/albümin oranı ve APACHE II skoru mortalitenin bağımsız öngördürücüleri olarak kalmıştır. CRP/albümin oranı, 6,20 eşik değerinde orta düzeyde ayırt edici güce sahipti (AUC: 0,632) ve bu değerde duyarlılık %48,8, özgüllük ise %73,4 olarak hesaplanmıştır.

Sonuç:
CRP/albümin oranı ve APACHE II skoru, yaşlı sepsis hastalarında mortalite ile bağımsız olarak ilişkili bulunmuştur. Bu erişilebilir ve düşük maliyetli parametreler, erken risk sınıflandırmasında fayda sağlayabilir ve YBÜ ortamında klinik karar verme süreçlerine rehberlik edebilir.

Anahtar Kelimeler

sepsis , APACHE II , geriatri , inflamatuar , yoğun bakım , mortalite

Prognostic significance of inflammatory biomarkers in predicting mortality among geriatric patients with sepsis in the intensive care unit

Öz

Aims: This study aims to investigate the prognostic significance of inflammatory biomarkers including the C-reactive protein (CRP)/albumin ratio, neutrophile-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and procalcitonin (PCT) in predicting mortality among geriatric patients with sepsis in the intensive care unit (ICU).
Methods: This retrospective study analyzed the medical records of 239 patients aged 65 years and older who were hospitalized with sepsis in the ICU between May and October 2023. Demographic characteristics, APACHE II scores, laboratory biomarkers (CRP, PCT, complete blood count), length of ICU stay and mortality outcomes were collected. Univariate and multivariate logistic regression analyses were used to determine predictors of mortality.
Results: The overall mortality rate was 66.9%. CRP, CRP/albumin ratio, mean platelet volume (MPV), red blood cell distribution width (RDW), lactate and APACHE II scores were significantly higher (p<0.05). In multivariate analysis only the CRP/albumin ratio and APACHE II score remained independent predictors of mortality. The CRP/albumin ratio showed moderate discriminatory power (AUC: 0.632) at a cutoff value of 6.20, with a sensitivity of 48.8% and a specificity of 73.4%.
Conclusion: The CRP/albumin ratio and APACHE II score were independently associated with mortality in elderly septic patients. These accessible and cost-effective parameters may aid in early risk stratification and guide clinical decision-making in the ICU setting.

Anahtar Kelimeler

Sepsis , APACHE II , elderly , inflammatory , intensive care units , mortality

Kaynakça

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