Acil Serviste Yatağa Bağımlı Hastalar: Onları Evlerinde Tedavi Edebilir Miyiz?

Yıl 2025, Cilt: 10 Sayı: 1, 69 - 75

Erdinç Şengüldür , Kudret Selki

https://doi.org/10.26453/otjhs.1610351

Öz

Amaç: Acil servise başvuran yatağa bağımlı hastaların demografik ve klinik özelliklerini ayrıntılı olarak incelemek ve evde bakım hizmetlerinin bu hasta grubuna uygulanabilirliğini değerlendirmek.
Materyal ve Metot: Bu çalışma, Düzce, Türkiye'deki üçüncü basamak bir üniversite hastanesinin acil servisinde yürütülen retrospektif, tek merkezli gözlemsel bir çalışmadır. 01.07.2021 - 01.07.2024 tarihleri arasında 1012 hasta ile yürütülmüştür. Dahil edilme kriterleri: herhangi bir nedenle tamamen yatağa bağımlı olmak. Dışlama kriterleri: Destekli veya desteksiz yürüyebilme, geçici olarak yatağa bağımlı olma.
Bulgular: Yatağa bağımlı hastaların oranı %0,003 idi. En sık başvuru nedeni 65 yaş altı hastalarda üriner kateter replasmanı (%24,2), yaşlı hastalarda ise genel durum bozukluğuydu (%25,6). Her iki grupta da en sık tanılar sırasıyla bakım ihtiyacı, pnömoni ve inme oldu. Ölen hastalarda 48 saat ve 30 gün içinde kalsiyum ve albümin değerleri hayatta kalanlara göre istatistiksel olarak anlamlı derecede düşük, BUN değerleri ise yüksekti (p<0.05).
Sonuç: Yatağa bağımlı hastaların kateter değişimi gibi ihtiyaçlarının evde karşılanması acil servis başvurularını ve acil servisteki yoğunluğu azaltacaktır. Kalsiyum, albümin ve ürik asit düzeyleri yatağa bağımlı hastalarda mortalite belirteçleri olarak araştırılmalıdır.

Anahtar Kelimeler

Acil servis, demans, evde bakım hizmetleri, inme, yatağa bağımlı

Bedridden Patients at Emergency Department: Can We Treat Them at Home?

Öz

Objective: To examine in detail the demographic and clinical characteristics of fully bedridden patients in emergency department (ED) and to evaluate the applicability of home care services to this patient group.
Materials and Methods: This was a retrospective, single-center observational study, conducted in the ED of a tertiary university hospital in Düzce, Türkiye. Study was conducted with 1012 patients between 01.07.2021 - 01.07.2024. Inclusion criteria: being fully bedridden for any reason. Exclusion criteria: Being able to walk with or without support and being temporarily bedridden.
Results: The rate of bedriddennes was 0.003%. The most common reason for admission was urinary catheter replacement (24.2%) in patients younger than 65 years and general condition disorder (25.6%) in elderly patients. The most common diagnoses in both groups were need of care, pneumonia and stroke, respectively. Calcium and albumin values within 48 hours and 30 days were found to be statistically significantly lower and BUN values were found to be higher in deceased patients compared to survivors. (p<0.05).
Conclusion: Meeting the needs of bedridden patients at home, such as catheter replacement, will reduce ED admissions and ED crowding. Calcium, albumin and uric acid levels should be investigated as mortality markers in bedridden patients.

Anahtar Kelimeler

Bedridden, emergency department, dementia, home care services, stroke

Kaynakça

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