Acil Servise Başvuran 90 Yaş ve Üstündeki Hastaların Değerlendirmesi

Yıl 2024, Cilt: 11 Sayı: 2, 68 - 75, 31.08.2024

Mustafa Alpaslan , Mehmet Oktay , Necmi Baykan

https://doi.org/10.47572/muskutd.1371126

Öz

Dünyada yaşlı nüfus oranının her geçen gün arttığı görülmektedir. Bununla birlikte acil servislerde de yaşlı hasta başvurusu oranı artmaktadır. Bu çalışmada acil servise başvuran 90 yaş ve üstündeki hasta grubunu analiz etmek amaçlanmıştır. Bu çalışmada 01.01.2022-31.12.2022 tarihleri arasında ikinci basamak olarak hizmet veren bir sağlık kuruluşunun acil servisine başvuran 90 yaş ve üzerindeki hastaların retrospektif değerlendirmesi yapıldı. Hastalarda yaş, cinsiyet, başvuru zamanı, başvuru şikâyeti, tanı, en sık hasta yatırılan klinikler ve sonlanım şekilleri değerlendirildi. Sonuçlar ortalama±standart sapma (SS) veya frekans (yüzde) şeklinde verilmiş ve p<0.05 istatistikî olarak anlamlı kabul edilmiştir. Çalışmada 754 hasta değerlendirildi. Yaş ortalaması 92.4±2.38’di. Kadın hasta oranı (%70.7) daha fazlaydı. En çok başvuru hafta içi mesai saatlerinde ve yaz aylarında yapıldı. En sık başvuru nedenleri nefes darlığı, düşme ve karın ağrısı oldu. En sık pnömoni, ekstremite kırığı ve akut böbrek yetmezliği teşhisi konuldu. Hastalarda en sık görülen ek hastalık hipertansiyondu. Hastaların %72.2’si acil servisten taburcu edildi. En sık hasta yatırılan klinikler göğüs hastalıkları, dahiliye ve ortopedi oldu. Hastanede ortalama yatış süresi 6 (1-91) gün olmuştur. Acil serviste veya yatırıldığı klinikte ölümle sonlanan hasta sayısı 63’tür (%8.3). En sık ölüm nedeni pnömoni ve akut miyokard infarktüsü oldu. Çalışmamızda ileri yaşlı hastalarda en sık pnömoni teşhisi konulduğu görüldü. Acil servise kişinin genel durumunda bozulma ile başvuran geriatrik hasta popülasyonunda pnömoni olabileceği mutlaka düşünülmelidir.

Anahtar Kelimeler

Acil Servis, Geriatri, Hospitalizasyon

Evaluation of Patients Aged 90 and Over Who Apply to the Emergency Department

Öz

It is seen that the rate of elderly population in the world is increasing day by day. However, the rate of elderly patient admissions in emergency departments is also increasing. In this study, a group of patients over the age of 90 who admitted to the emergency department was analyzed. In this study, a retrospective evaluation was made of patients aged over 90 who admitted to the emergency department of a secondary care health institution between 01.01.2022 and 31.12.2022. The information about patients’ age, gender, time of acceptance, acceptance complaint, diagnosis, clinics where patients were most frequently admitted, and their results were evaluated. Results are presented as mean±standard deviation (SD) or frequency (percentage), and p<0.05 was considered statistically significant. 754 patients were evaluated in the study. The mean age was 92.4±2.38. The proportion of female patients was higher (70.7%). Most acceptance were made during weekday working hours and summer months. The most common reasons for accept were shortness of breath, falling and abdominal pain. The most common diagnoses were pneumonia, extremity fracture and acute renal failure. The most common co-morbidity in the patients was hypertension. 72.2% of the patients were discharged from the emergency department. The clinics where patients were most frequently admitted were chest diseases, internal medicine and orthopedics. The average length of hospitalization was 6 (1-91) days. The number of patients who died in the emergency department or in the hospitalized clinic was 63 (8.3%). The most common causes of death were pneumonia and acute myocardial infarction. In our study, pneumonia was diagnosed most frequently in elderly patients. Pneumonia should be considered in the geriatric patient population presenting to the emergency department with deterioration in general condition.

Anahtar Kelimeler

Emergency Service, Geriatrics, Hospitalization

Kaynakça

• 1. Cilingiroglu N, Demirel S. Old age and elderly discrimination. Turk J Geriatr. 2004;7(4):225-30.
• 2. Kekec Z, Koc F, Büyük S. Review of elderly patient hospitalizations in the emergency department. J Acad Emerg Med. 2009;8(3):21-4.
• 3. Beger T, Yavuzer H. Epidemiology of aging and old age. Clin Dev. 2012;25:1-3.
• 4. Satar S, Sebe A, Avcı A, et al. Elderly patient and emergency service. J Çukurova Univ Fac Med. 2004;29:43-50.
• 5. Singal BM, Hedges JR, Rousseau EW, et al. Geriatric patient emergency visits. part 1: comparison of visits by geriatric and younger patients. Ann Emerg Med. 1992;21:802-7.
• 6. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med. 2002;39(3):238-47.
• 7. Ross MA, Compton S, Richardson D, et al. The use and effectiveness of an emergency department observation unit for elderly patients. Ann Emerg Med. 2003;41(5):668-77.
• 8. Varıslı B. Clinical, demographic and cost investigation of geriatric age group patients applying to the emergency department. Anatolian J Emerg Med. 2018;1(2):18-24.
• 9. Bedel C, Tomruk O. Characteristics of geriatric patients presenting to a university emergency department. SDU Fac Med J. 2018;25(4):393-9.
• 10. Celik P, Celik S, Hastaoglu F. Determination of geriatric patient profile applying to the emergency department. J Geriatr Sci. 2022;5(3):72-80.
• 11. Lewis LM, Banet GA, Blanda M, et al. Etiology and clinical course of abdominal pain in senior patients: a prospective, multicenter study. J Gerontol A Biol Sci Med Sci. 2005;60(8):1071-6.
• 12. Oktem B, Uzer F. General characteristics of geriatric patient population applying to emergency department. Kocatepe Med J. 2022;23(3):283-7.
• 13. Dundar ZD, Ayrancı MK. Evaluation of demographic characteristics and prognosis of geriatric patients presenting to the emergency department with abdominal pain. Selcuk Med J. 2021;37(1):45-51.
• 14. Unsal A, Cevik AA, Metintas S, et al. Emergency department admissions of elderly patients. Turk J Geriatr. 2003;(6):83-8.
• 15. Wilber ST, Gerson LW. A research agenda for geriatric emergency medicine. Acad Emerg Med. 2003;(10):251-60.
• 16. Logoglu A, Ayrık C, Kose A, et al. Investigation of demographic characteristics of non-traumatic geriatric cases presenting to the emergency department. Turkish J Emerg Med. 2013;13(4):171-9.
• 17. Gurmen ES, Tulay CM. Geriatric patients in the emergency department: respiratory distress and chest pain. Van Tıp Derg. 2019;26(2):232-5.
• 18. Aslaner MA. Readmission of geriatric patients to the emergency department within 72 hours. Acta Medica Alanya. 2019;3(3):267-71.
• 19. Tinetti ME. Approach to the elderly patient with falls. In Kelley WN (ed): Textbook of Internal Medicine, ed 3. Phladelphia, Lippincott-Raven, 1997, pp: 2525-2530.
• 20. Tanrıkulu CS, Tanrıkulu Y. Trauma analysis in geriatric population: a cross-sectional study. New Med J. 2013;30(2):100-4.
• 21. Schwab CW, Kauder DR. Trauma in the geriatric patient. Arch Surg.1992;127(6):701-6.
• 22. Osler T, Hales K, Baack B, et al. Trauma in the Elderly. Am J Surg. 1988;156(6):537-43.
• 23. Yıldız S, Bilgili N. Individual characteristics of elderly patients admission to the emergency department and evaluation of applications. Gazi Health Sci J. 2016;1(1):15-31.
• 24. McCusker J, Bellavance F, Cardin S, et al. Prediction of hospital utilization among elderly patients during the 6 months after an emergency department visit. Ann Emerg Med. 2000;36:438-45.
• 25. Arslan Ş, Atalay A, Gökçe Kutsal Y. Drug use in older people. J Am Geriatr Soc. 2002;50(6):1163-8.
• 26. Mert E. Emergency service utilization of geriatric patients. Turk J Geriatrics. 2006; 9(2): 70-4.