Acil Serviste İdrar Sondası Takılma Nedenlerinin Analizi

Yıl 2023, , 223 - 229, 01.11.2023

Mehmet Murat Diyar , Fatih Çakmak , Yonca Senem Akdeniz , Serap Biberoğlu , Turker Demırtakan , Eren Tatoğlu

https://doi.org/10.38175/phnx.1367749

Öz

Amaç: Acil serviste hastalara uygulanan idrar sondası işleminin nedenleri analiz edildi. Bu şekilde uygunsuz endikasyonla takılan idrar sondalarının ve sondaya bağlı komplikasyonların oranlarını göstererek bu tıbbi uygulamanın gözden geçirilmesi hedeflendi.
Gereç ve Yöntem: Bu çalışma 01/05/2022-01/11/2022 tarihleri arasında yetişkin acil serviste idrar sondası takılan hastaların dosyaları ve hastane sistemindeki bilgileri incelenerek retrospektif olarak gerçekleştirildi. Hastaların yaşı, cinsiyeti, kullandığı ilaçlar, bilinen hastalıklar, geçirilmiş operasyon öyküsü, idrar sondası takılma nedenleri, komplikasyonlar ile ilişkili olabilecek laboratuvar verileri, gelişen komplikasyonlar, acil servisten çıkış durumları kayıt edilerek analiz edildi.
Bulgular: Olguların yaş ortalaması 65,04±19,85 yıl, ortanca yaş 68 olarak tespit edildi. Hipertansiyon %,50,3 (n=264) ile en sık görülen ek hastalıktı. Günlük aldığı çıkardığı takibi ile tanı ve tedavi amaçlı günlük diürez ölçümü %38,3 (n=201) ile en sık sonda takılma nedeni idi. Uygunsuz endikasyonla takılan sonda oranı %14,7 olarak bulundu. Olgular incelendiğinde tespit edilen komplikasyon gelişimi %8,6 olarak tespit edilmiştir. %5,3’ünde bakteriüri geliştiği görülmüştür. Hematürinin %2,7 ve üretral yaralanmanın %0,6 olguda yaşandığı izlendi
Sonuç: Bu veriler sonda takma nedenlerini acil servise yönelik özelleşmesine ve analizine yardımcı olmuştur. Acil servis için daha gerçekçi bir veri oluşturmuş, acilde uygunsuz endikasyonla sonda takılmasının ve komplikasyonlarının belirlenmesini sağlamıştır. Bu istenmeyen durumlara karşı azaltıcı yönde acil hekimlerine ve sağlık personeline katkı sağlayacaktır.

Anahtar Kelimeler

Bakteriüri, Acil servis, Uygunsuz endikasyon, İdrar sondası, İdrar sondası takılması

Analysis of the Reasons for Urinary Catheterization in the Emergency Service

Öz

Objective: The study aims to determine the rate of urinary catheter insertions with an inappropriate indication in the emergency room, to analyze justifications for these insertions, and to revise these justifications revealing catheter-related complication rates.
Material and Method: This study has been retrospectively conducted by analyzing records of patients having urinary catheterization at the emergency department, between 01/05/2022-01/11/2022. The age, gender, medications, comorbidities, operation history, urinary catheterization reason, catheterization complications, laboratory data that might be related to the complications, and final disposition of the patient.
Results: The mean age of the cases was 65.04±19.85 years, and the median age was 68 years. Hypertension was the most common comorbidity with a percentage of 50.3 (n=264). Daily diuresis measurement for diagnosis and treatment, and daily hydration and diuresis follow-up were the most common reason for urinary catheter insertion with a rate of 38.3% (n=201). The rate of insertions with inappropriate indication was %14.7. The complication percentage was 8,6%. Bacteriuria rate was 5.3%. Hematuria with a rate of 2.7% and urethral injury with a rate of 0.6% was observed among the cases.
Conclusion: These data enabled the analysis of urinary catheter insertions in the emergency department. It provided more accurate data for emergency rooms and assisted in the identification of inappropriate indication catheterization rates and complications at the emergency department. This study will contribute to the emergency physicians and health workers reducing catheterizations with inappropriate indications and related complications.

Anahtar Kelimeler

Bacteriuria, Emergency service, Inappropriate indication, Urinary catheter, Urinary catheterization

Kaynakça

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