Hemodiyaliz Hastalarında Semptom Yükü Deprem Sonrasında Artar mı? Prospektif Bir Kohort Çalışması

Öz

Amaç: Hemodiyalize (HD) giren hastalar, hastalığın kendisinden, tedavisinden veya komorbid durumlarından dolayı birçok semptomla karşılaşırlar. Bu çalışmanın amacı HD hastalarında semptom yükünün deprem öncesi ve deprem sonrası üçüncü ve altıncı aylarda prospektif olarak değerlendirilmesi ve karşılaştırılmasıdır. Gereç ve Yöntemler: 6 Şubat 2023 tarihli Kahramanmaraş depremleri öncesi diyaliz semptom indeksi (DSİ) değerlendirmesi yapılmış, depremlerden üç ve altı ay sonra HD tedavisine ünitemizde devam eden 75 birey dahil edildi. Semptom yükü 30 sorudan oluşan bir anket olan DSİ ile değerlendirildi. Deprem öncesi verileri Kasım-Aralık 2022, deprem sonrası üçüncü ay verileri Mayıs 2023 ve altıncı ay verileri Ağustos 2023’te toplandı. Bulgular: Yaş ortalaması 58±14 olan 75 bireyin 26‘sı(%33.8) kadındı. Bireylerin deprem öncesi ortanca 19[12-23] semptomu mevcutken, deprem sonrası üçüncü ayda ortanca 22[19-25] ve altıncı ayda ortanca 22[17-24] semptomu vardı(p<0.001). Semptom sayısı hem deprem sonrası üçüncü ayda hem de deprem sonrası altıncı ayda deprem öncesine göre anlamlı derecede arttı (ikisi için de p<0.001). Deprem sonrası altıncı ayda deprem sonrası üçüncü aya göre semptom sayısı anlamlı derecede azaldı (p=0.002). DSİ skoru; deprem öncesinde ortanca 51[29-71], deprem sonrası üçüncü ayda ortanca 71[51-82] ve deprem sonrası altıncı ayda ortanca 63[40-76] idi(p<0.001). DSİ skoru, hem deprem sonrası üçüncü ayda hem de deprem sonrası altıncı ayda deprem öncesine göre anlamlı derecede arttı(ikisi için de p<0.001). DSİ skoru, deprem sonrası altıncı ayda deprem sonrası üçüncü aya göre anlamlı derecede azaldı(p<0.001). Sonuç: HD hastalarında yüksek olan semptom yükünün deprem gibi büyük travmalar sonrası dönemde daha da arttığını gösterdik. Artmış semptom yükünün deprem sonrası farkında olmak ve takip etmek erken müdahale şansı sağlayabilir.

Anahtar Kelimeler

• Deprem
• hemodiyaliz
• semptom yükü

Could The Symptom Burden in Hemodialysis Patients Increase After Earthquake? A Prospective Cohort Study

Öz

Aim: Patients on hemodialysis (HD) experience many symptoms due to the disease itself, its treatment or comorbid conditions. The aim of the study was to prospectively evaluate and compare the symptom burden in HD patients before the earthquake and in the third and sixth months after the earthquake. Material and Methods: 75 individuals who were evaluated with Dialysis symptom index (DSI) before the Kahramanmaraş earthquakes on February 6, 2023 and who continued HD treatment in our unit three and six months after the earthquakes were included. Symptom burden was assessed with the DSI, a questionnaire consisting of 30 questions. Pre-earthquake data were collected in November-December 2022, third month post-earthquake data in May 2023 and sixth month data in August 2023. Results: Of the 75 individuals with a mean age of 58 years, 26(33.8%) were women. While individuals had an median of 19[12-23] symptoms before the earthquake, they had an median of 22[19-25] symptoms in the third month and median of 22[17-24] symptoms in the sixth month after the earthquake(p<0.001). The number of symptoms increased in both the third post-earthquake month and the sixth post-earthquake month compared to before the earthquake(p<0.001 for both). The number of symptoms decreased in the sixth month after the earthquake compared to the third month after the earthquake(p<0.001). The median DSI score was 51[29-71] before the earthquake, 71[51-82] in the third month after the earthquake, and 63[40-76] in the sixth month after the earthquake(p<0.001). DSI score increased in both the third and sixth post-earthquake months compared to the pre-earthquake period(p<0.001 for both). DSI score decreased in the sixth post-earthquake month compared to the third post-earthquake month(p<0.001). Conclusion: We showed that the symptom burden, which is high in HD patients, increases further in the period after major traumas such as earthquakes. Recognizing and monitoring the increased symptom burden after an earthquake may provide a chance for early intervention

Anahtar Kelimeler

• Earthquake
• hemodialysis
• symptom burden

Kaynakça

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