Acil Servise Başvuran 65 Yaş ve Üzeri İntrakranial Kanaması Olan Hastaların Demografik ve Epidemiyolojik Özelliklerinin Analizi

Öz

Bu çalışmanın amacı acil servise başvuran ≥65 yaş intrakranial kanaması olan hastaların demografik ve epidemiyolojik özelliklerinin incelenmesi ve klinik sonlanımları ile ilişkili faktörlerin belirlenmesidir. Kesitsel tipte olan bu çalışma, 1 Ocak 2018 – 31 Aralık 2022 tarihleri arasında acil serviste intrakranial kanama tanısı alan ≥65 yaş olguların dosyalarının retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Olguların %57,6’sı erkekti ve yaş ortalaması 75,49 ± 7,43 yıldı. Olguların %79,9’unda en az bir ek hastalık, %46,0’ında travma öyküsü vardı. Bilgisayarlı Tomografi sonucunda en sık saptanan kanama türleri %39,1 subdural, %38,6 intraparankimal ve %26,1 subaraknoid kanama idi. Klinik sonlanım açısından bakıldığında; olguların %7,6’sının acil servisten taburcu edildiği %21,2’sinin yoğun bakım ünitesine yatırıldığı, %29,9’unın dış merkez yoğun bakım ünitesine sevk edildiği ve %1,6’sının ise exitus olarak sonlandığı görüldü. Diğer olgularla karşılaştırıldığında, klinik sonlanımı olarak yoğun bakım ünitesi yatış/ sevk/ ölüm olan olgular arasında kadın cinsiyet sıklığı ve subdural kanama sıklığı istatistiksel olarak anlamlı düzeyde daha yüksek iken; Glasgow Koma Skoru ve intraparankimal kanama sıklığı ise anlamlı düzeyde daha düşüktü. Sonuç olarak klinik pratikte özellikle kranial BT’de subdural hematom saptanan ve GKS skoru düşük yaşlı intrakranial kanamalı olgularda kötü sonlanım riskinin daha fazla olduğunu göz önünde bulundurularak, erken dönemde doğru tedavinin uygulanmasının sağ kalımı artıracak çabalar arasında yer alacağı düşünülmektedir.

Anahtar Kelimeler

• acil servis
• Glasgow Koma Skoru
• intrakranial kanama

Analysis of Demographic and Epidemiologic Characteristics of Patients 65 Years and Older with Intracranial Hemorrhage Presenting to the Emergency Department

Öz

The aim of this study is to examine the demographic and epidemiological characteristics of patients with intracranial hemorrhage aged ≥65 years who applied to the emergency department and to determine the factors associated with their clinical outcomes. This cross-sectional study was conducted by retrospectively evaluating the files of patients aged ≥65 years who were diagnosed with intracranial hemorrhage in the emergency department between January 1, 2018 and December 31, 2022. 57.6% of the cases were male, and the mean age was 75.49 ± 7.43 years. In 79.9% of the cases, there was at least one comorbidity, and 46.0% had a history of trauma. The most frequently identified types of hemorrhage on Computed Tomography were 39.1% subdural, 38.6% intraparenchymal, and 26.1% subarachnoid hemorrhage. In terms of clinical outcomes, 7.6% of the cases were discharged from the emergency department, 21.2% were admitted to the intensive care unit, 29.9% were transferred to an external center’s intensive care unit, and 1.6% resulted in death. Compared to other cases, among those with intensive care unit admission/transfer/death, female gender and subdural hemorrhage were statistically significantly higher, while Glasgow Coma Score and intraparenchymal hemorrhage frequency were significantly lower. In conclusion, considering that in clinical practice, the risk of poor outcome is higher in elderly patients with intracranial hemorrhage, especially those with subdural hematoma detected on cranial CT and with low GCS scores, it is thought that the implementation of treatment modalities in the early period will be among the efforts to increase survival rate.

Anahtar Kelimeler

• emergency department
• intracranial hemorrhage
• glasgow coma scale

Kaynakça

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