Thrombolytic therapy experience in an secondary care emergency department

Yıl 2019, Cilt: 12 Sayı: 2, 309 - 314, 28.05.2019

Mehmet Ali Aslaner , Necmi Baykan

https://doi.org/10.31362/patd.515838

Cited By: 1

Öz

Purpose:
Although thrombolytic therapy is frequently used and the usage rates are well
defined in university and education-research hospitals in our country,
secondary care emergency departments (ED) utilization rates in national
literature are not known. With this study, it was aimed to create a new data
set which is insufficient in our country.

Materials
and Methods: The study was carried out retrospectively
between 2006 and 2008 in the secondary care ED of the biggest hospital of
........... province. Data set were included diagnoses, active substance,
complication status and 3-months mortality in addition to demographic
characteristics.

Results:
During the study period, 57 patients received thrombolytic therapy. The median
age of the patients was 68 (IQR 54-79) and the male gender ratio was 70.2%. The
frequency of thrombolytic therapy was 1.8 / 10.000 in all ED visits. Of all
diagnoses; the incidence of ischemic stroke was 50.9%, acute myocardial
infarction was 29.8%, arrest etiology was 10.5% and pulmonary thromboembolism
was 8.8%. Alteplase was used in 75.4% of the cases and tenecteplase was used in
24.6%. The mortality rate was 57.9% in all patients.

Conclusion:
Thrombolytic therapy was more frequently performed in patients with ischemic
stroke. Alteplase was the most commonly used thrombolytic agent because of its
wide spectrum of indications. It was thought that thrombolytic usage is very
low in in the secondary care emergency departments.

Anahtar Kelimeler

emergency department, thrombolytic therapy, alteplase, tenekteplase

İkinci basamak bir acil serviste trombolitik tedavi deneyimi

Öz

Amaç:
Trombolitik tedavi, ülkemizde üniversite ve eğitim-araştırma hastanelerinde
sıklıkla uygulanmakta ve kullanım oranları daha net olarak tanımlanmış olmasına
rağmen, ulusal literatürde ikinci basamak acil servis kullanım oranları
bilinmemektedir. Bu çalışma ile ülkemizde eksik olan, ikinci basamağa ait yeni
bir veri seti oluşturmak amaçlanmıştır.

Yöntem:
Çalışma 2006-2008 yılları arasında geriye dönük olarak, ........... ilinin en
büyük hastanesinin ikinci basamak acil servisinde gerçekleştirildi. Veri seti;
demografik özelliklerin yanı sıra, tanılar, kullanılan etken madde,
komplikasyon durumu ve 3 aylık mortalite olarak belirlendi.

Bulgular:
Çalışma periyodu boyunca 57 hastaya trombolitik tedavi verildi. Hastaların
ortanca yaşı 68 (IQR 54-79) ve erkek cinsiyet oranı %70,2 idi. Tüm çalışma
boyunca trombolitik tedavi kullanım sıklığı 1,8/10.000 acil servis başvurusu
olarak saptandı. Trombolitik tedavi uygulanan tanılar içerisinde; iskemik inme
%50,9 oranında, akut miyokard enfarktüsü %29,8, arrest etiyolojisi %10,5 ve pulmoner
tromboemboli %8,8 oranındaydı. Kullanılan ajanlardan alteplaz %75,4 oranında ve
tenekteplaz %24,6 oranında uygulandı. Tedavi uygulanan tüm hastaların 3 aylık
mortalite oranı %57,9’ idi.

Sonuç: Çalışmada, trombolitik tedavi uygulamasının
daha sıklıkla iskemik inme hastalarında uygulandığı görüldü. Alteplaz, geniş
endikasyon spektrumu nedeniyle en sık kullanılan trombolitik ajandı. Çalışma
sonucunda trombolitik kullanımının, özellikle ikinci basamak acil servislerde
oldukça düşük oranda olduğu düşünüldü.

Anahtar Kelimeler

acil servis, trombolitik tedavi, alteplaz, tenekteplaz

Kaynakça

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