Acil kolorektal cerrahi yapılan hastalarda mortaliteyi öngörmede Amerikan Anesteziyoloji Derneği Sınıflaması (ASA) ve Charlson Komorbidite İndeksi (CCI)’nin karşılaştırılması

Öz

Amaç: Acil kolorektal cerrahi yapılan hastalarda kolay uygulanabilir ve pratik olan ASA (Amerikan Anesteziyoloji Derneği Sınıflaması) ve CCI (Charlson Komorbidite İndeksi) gibi skorlama sistemlerini kullanarak preoperatif değerlendirme ile mortaliteyi öngörebilmeyi amaçladık.

Gereç ve Yöntemler: Ocak 2014 -Aralık 2017 tarihleri arasında Sağlık Bilimleri Üniversitesi Ankara Numune Eğitim ve Araştırma Hastanesi Genel Cerrahi/Acil Cerrahi Kliniğine başvuran AKC  yapılan 198 hastanın verileri retrospektif olarak incelendi. Hastaların demografik özellikleri, klinik tanıları, uygulanan cerrahi tipi, postoperatif komplikasyonlar, komorbiditeler, ASA ve CCI skorları elektronik veri tabanından elde edildi.

Bulgular:198 hastanın 95’i (%47,9) kadın ve 103’ü (%52,1) erkek idi. Ortanca yaş 62 (23 -93) olarak bulundu. 49(% 24) hastada mortalite gelişti. Mortalite gelişen hastaların ortanca ASA skoru: 4, CCI: 5 ve mortalite gelişmeyen hastaların ortanca ASA skoru: 3, CCI: 5 idi. Mortalite için ASA skoru istatistiksel olarak anlamlı bulundu (ASA için p=0,001 ve CCI için p=0,611).

Sonuç: Bu çalışmanın, yüksek riskli hastaların yönetiminde pratik olarak kullanılabilecek basit ve yararlı veri sağladığına inanmaktayız. Acil kolorektal cerrahide, mortaliteyi öngörmede ASA skoru hızlı uygulanabilir ve yeterli bir skorlamadır.

Anahtar Kelimeler

• Mortalite; acil kolorektal cerrahi; ASA skoru ve CCI

Comparison of American Society of Anesthesiology Classification and Charlson's Comorbidity Index for predicting mortality in emergency colorectal surgery

Öz

Aim: We aimed to predict mortality by using preoperative evaluation scoring systems such as ASA (American Society of Anesthesiologists Classification) and CCI (Charlson Comorbidity Index), which are easily practicable in emergency colorectal surgery patients.

Material and Methods: The data of 198 patients with Emergency Colorectal Surgery (ECS) who applied to Ankara Numune Training and Research Hospital General Surgery / Emergency Surgery Clinic of Health Sciences University between January 2014 and December 2017 were retrospectively analyzed. Demographic characteristics, clinical diagnoses, type of surgery, postoperative complications, comorbidities, ASA and CCI scores were obtained from electronic databases.

Results: Of the 198 patients, 95 (47.9%) were female and 103 (52.1%) were male. The median age was 62 (23 -93). 49 (%24) mortality was seen in patients. The median ASA score was 4, the CCI was 5 in patients with mortality; and the median ASA score was 3, CCI was 5 in patients with no mortality. The ASA score for predicting mortality was found statistically significant (respectively p value for ASA and CCI; 0.001 and 0.611).

Conclusion: We believe this study provides simple and useful data that can be used practically in the management of high-risk patients. In emergency colorectal surgery, ASA score is quickly applicable and adequate score for predicting mortality.

Anahtar Kelimeler

• mortality,emergent colorectal surgery,ASA scora,CCI

Kaynakça

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