Acil serviste yaşlı hastaların takipleri sırasında hastane içi kardiyopulmoner arrestlerin ve mortalitenin sebepleri: retrospektifbir çalışma

Öz

Amaç: Bu çalışma, acil servise başvuran yaşlı hastalarda kardiyopulmoner arrest (KPA) gelişimini etkileyen faktörleri, spontan dolaşımın geri dönme (SDGD) olasılığını ve sağkalım oranlarını belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: 1 Eylül 2022 - 31 Ağustos 2024 tarihleri arasında Esenyurt Necmi Kadıoğlu Devlet Hastanesi acil servisine KPA ile başvuran 65 yaş ve üzeri 500 hastanın verileri retrospektif olarak analiz edildi. Veriler, hastanenin elektronik tıbbi kayıtlarından elde edilerek demografik bilgiler, komorbiditeler, klinik özellikler, resüsitasyon işlemleri ve sağkalım oranları incelendi. İstatistiksel analizler SPSS sürüm 26.0 kullanılarak yapıldı. Bulgular: Hastaların ortalama yaşı 79,67 ± 8,99 yıl olup, en yaygın komorbiditeler hipertansiyon (%52,6), KOAH (%40,2) ve kardiyovasküler hastalıklar (%35,4) olarak tespit edildi. SDGD sağlayan hastalarda resüsitasyona daha erken başlandığı ve oksijen desteği ile mekanik ventilasyonun SDGD oranlarını anlamlı derecede artırdığı görüldü (p < 0,05). 24 saatlik sağkalım oranı %65 ± 10, 30 günlük sağkalım oranı %45 ± 10 ve hastane içi mortalite oranı %55 ± 10 olarak hesaplandı. Sonuç: Komorbiditelerin etkili yönetimi ve zamanında yapılan müdahaleler, KPA riskini azaltmada ve yaşlı hastalarda sağkalım oranlarını iyileştirmede kritik öneme sahiptir. Erken ve etkili resüsitasyon stratejileri sağkalım sonuçlarını önemli ölçüde iyileştirmektedir. Klinik yönetim protokollerini optimize etmek için daha geniş hasta gruplarıyla yapılacak ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• kardiyopulmoner arrest
• spontan dolaşımın geri dönmesi
• yaşlı hastalar
• acil servis
• komorbiditeler
• sağkalım oranları
• resüsitasyon
• hipertansiyon
• KOAH
• kardiyovasküler hastalıklar

Causes of in-hospital cardiopulmonary arrests and mortality during the follow-up of elderly patients in the emergency department: a retrospective study

Öz

Aim: This study aimed to identify the factors affecting the development of cardiopulmonary arrest (CPA), the probability of return of spontaneous circulation (ROSC), and survival rates in elderly patients admitted to the emergency department. Material and Methods: A retrospective analysis was conducted on data from 500 patients aged 65 years and older who presented with CPA at Esenyurt Necmi Kadıoğlu State Hospital's emergency department between September 1, 2022, and August 31, 2024. Data were collected from the hospital's electronic medical records, including demographic information, comorbidities, clinical characteristics, resuscitation procedures, and survival rates. Statistical analysis was performed using SPSS version 26.0. Results: The mean age of the patients was 79.67 ± 8.99 years, with hypertension (52.6%), COPD (40.2%), and cardiovascular diseases (35.4%) being the most common comorbidities. Patients who achieved ROSC had earlier initiation of resuscitation, and oxygen support along with mechanical ventilation significantly improved ROSC rates (p < 0.05). The 24-hour survival rate was 65% ± 10, the 30-day survival rate was 45% ± 10, and the in-hospital mortality rate was calculated as 55% ± 10. Conclusion: Effective management of comorbidities and timely interventions are essential for reducing CPA risk and improving survival rates in elderly patients. Early and efficient resuscitation strategies significantly improve survival outcomes. Further studies with larger cohorts are recommended to optimize clinical management protocols.

Anahtar Kelimeler

• cardiopulmonary arrest
• return of spontaneous circulation
• elderly patients
• emergency department
• comorbidities
• survival rates
• resuscitation
• hypertension
• COPD
• cardiovascular diseases

Destekleyen Kurum

No funding was received for this study.

Etik Beyan

This study was approved by the Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee (Approval No: E-10840098-202.3.02-765, Date: 24/01/2025).

Kaynakça

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