Mantar Zehirlenmesiyle Acil Servise Başvuran Hastaların Karakteristik Özellikleri ve Laboratuvar Parametrelerinin Prognoz Tayininde Rolü

Abstract

Amaç: Bu çalışmada acil servise mantar yeme sonrası gelişen zehirlenme tablosu ile başvuran hastaların genel karakteristiklerinin araştırılması ve olası prognostic faktörlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma Samsun, Türkiye’deki bir üniversite hastanesi acil servisine 6 yıl içerisinde mantar zehirlenmesi ile başvuran 18 yaş ve üzerindeki hastaların kayıtlarının geriye dönük olarak incelenmesi ile yapıldı. Çalışmada mortalite öngördürücü ve zehirlenme ciddiyetini gösteren modeller kullanılarak hastalar gruplandırıldı. Son dönem karaciğer hastalığı için model (MELD) skorlaması ve zehirlenme şiddet skoru (PSS) bu amaçla kullanıldı. Bu çalışmaya ait elde edilen tüm veriler Statistical Package for Social Sciences (SPSS) for Windows 15.0 paket programı kullanılarak analiz edildi. Bulgular: Mantar zehirlenmesi ile acil servise başvuran 471 hastadan 16 tanesinde karaciğer yetmezliği geliştiği saptandı. Karaciğer yetmezliği gelişmeyen 455 hastada semptom başlangıç süresinin ortalama 2 saat olduğu, karaciğer yetmezliği gelişen 16 hastada ise semptom başlangıç süresinin ortalama 9,5 saat olduğu saptandı. Mantar zehirlenmeli hastalar PSS’sine göre sınıflandırıldığında, hastalarımızın %91,1’i PSS 1 olarak acil servise başvurmuş iken, %2,1’i ise şiddetli semptomlarla acil servise başvurmuştu. Mantar zehirlenmesiyle gelen hastaların %93,6’sı MELD skoru hafif olan hastalardı. Sonuç: Mantar intoksikasyonu olgularında en sık klinik bulgu bulantı ve kusmadır. Mantar intoksikasyonu hastalarında semptomların 2 saat içerisinde ortaya çıkması iyi prognoz göstergesidir. MELD skoruna göre Bun değeri yükseldikçe hastalık ciddiyeti de artmaktadır. Aynı zamanda BUN ve amilaz değeri yüksekliği PSS’ye göre hayatı tehdit edici bir zehirlenme açısından hekimi uyarıcı roldedir.

Keywords

• mantar
• zehirlenme
• acil servis
• laboratuar parametreleri

Characteristics of Patients Presenting to the Emergency Department with Mushroom Poisoning and the Role of Laboratory Parameters in Determining Prognosis

Abstract

Aim: In this study it is aimed to investigate the general characteristics of the patients of mushroom poisoning in the emergency department and to determine the possible prognostic factors. Material and Methods: This study was conducted by retrospectively examining the records of patients who applied to the emergency department of a university hospital in Samsun, Turkey, with mushroom poisoning in 6 years. Patients were grouped using models that predict mortality and the severity of poisoning. Model for end stage liver diseases (MELD) scoring and poisoning severity score (PSS) were used for this purpose. All data obtained from this study were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows 15.0 package program. Results: Liver failure developed in 16 of 471 patients who applied with mushroom poisoning. The median symptom onset time was 2 hours in 455 patients who did not develop liver failure, and the median symptom onset time was 9.5 hours in 16 patients who developed liver failure. When the patients were classified according to PSS, 91.1% of patients applied with PSS 1, while 2.1% of them applied with severe symptoms. 93.6% of the patients were with a mild MELD score. Conclusion: The most common clinical finding is nausea and vomiting. The appearance of symptoms within 2 hours is an indicator of a good prognosis. According to the MELD score, the severity of the disease increases as the BUN value increases. At the same time, high BUN and amylase levels mean a life-threatening poisoning according to PSS.

Keywords

• mushroom
• poisoning
• emergency department
• laboratory parameters

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