.: ORİJİNAL ARAŞTIRMA
Hematolojik Maligniteli Yoğun Bakım Hastalarının Değerlendirilmesi
Evaluation of Critically Ill Patients with Hematological Malignancies
Turkiye Klinikleri J Anest Reanim. 2020;18(3):79-85
doi: 10.5336/anesthe.2019-73223
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Hematolojik malignite (HM)li hastalarda hastalığın ilerlemesi, tedavi komplikasyonları ve gelişen organ yetersizlikleri nedeniyle yoğun bakım ünitesi (YBÜ)ne yatış gerekebilir. YBÜ'ye yatan HM'li erişkin hastalarda mortalitenin ve buna etki eden faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntemler: 2010-2018 yılları arasında YBÜ'de 24 saatten uzun süre yatan HM tanılı hastalar, retrospektif olarak incelendi. Hastalar, mortalite üzerine etkili faktörler açısından karşılaştırıldı. Bulgular: Çalışmaya dâhil edilen 99 HM hastasının mortalitesi %86 idi. YBÜ'ye ilk yatışlarındaki APACHE II ve SOFA skorları ile YBÜ yatışları süresince invaziv mekanik ventilasyon (İMV) uygulaması ve vazopresör tedavisi ihtiyacı anlamlı derecede yüksek saptandı (p<0,05). HM'nin tipinin mortalite üzerine fark yaratmadığı görüldü (p<0,05). Sonuç: HM'li kritik hastaların, yoğun bakım mortalitesi yüksek olduğu ve bu hastaların, YBÜ'ye yatışlarında vazopresör desteği ve İMV ihtiyacının olmasının, mortalitenin artmasında etkili olduğu görülmüştür.
Anahtar Kelimeler: Yoğun bakım; mortalite; hematolojik maligniteler
Amaç: Hematolojik malignite (HM)li hastalarda hastalığın ilerlemesi, tedavi komplikasyonları ve gelişen organ yetersizlikleri nedeniyle yoğun bakım ünitesi (YBÜ)ne yatış gerekebilir. YBÜ'ye yatan HM'li erişkin hastalarda mortalitenin ve buna etki eden faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntemler: 2010-2018 yılları arasında YBÜ'de 24 saatten uzun süre yatan HM tanılı hastalar, retrospektif olarak incelendi. Hastalar, mortalite üzerine etkili faktörler açısından karşılaştırıldı. Bulgular: Çalışmaya dâhil edilen 99 HM hastasının mortalitesi %86 idi. YBÜ'ye ilk yatışlarındaki APACHE II ve SOFA skorları ile YBÜ yatışları süresince invaziv mekanik ventilasyon (İMV) uygulaması ve vazopresör tedavisi ihtiyacı anlamlı derecede yüksek saptandı (p<0,05). HM'nin tipinin mortalite üzerine fark yaratmadığı görüldü (p<0,05). Sonuç: HM'li kritik hastaların, yoğun bakım mortalitesi yüksek olduğu ve bu hastaların, YBÜ'ye yatışlarında vazopresör desteği ve İMV ihtiyacının olmasının, mortalitenin artmasında etkili olduğu görülmüştür.
Anahtar Kelimeler: Yoğun bakım; mortalite; hematolojik maligniteler
ABSTRACT
Objective: Patients with hematologic malignancy (HM) may require intensive care due to disease progression, treatment-related complications and developing organ deficiencies. To investigate mortality and prognostic variables in adult patients who admitted to intensive care unit (ICU). Material and Methods: Patients with HM who were hospitalized in the ICU for more than 24 hours between 2010 and 2018 were retrospectively analyzed. Patients were compared in terms of factors effecting the mortality. Results: The mortality rate of 99 HM patients who were inclueded in the study was 86%. APACHE II and SOFA scores and the need for invasive mechanical ventilation and vasopressor treatment during ICU hospitalizations were significiantly high in exitus group (p<0.05). It was seen that the type of HM did not make any difference on mortality (p<0.05). Conclusion: Mortality is high in critically ill patients with HM and it is seen that the need for vasopressor support is influential especially during admission to ICU.
Keywords: Critical care; mortality; hematologic malignancies
Objective: Patients with hematologic malignancy (HM) may require intensive care due to disease progression, treatment-related complications and developing organ deficiencies. To investigate mortality and prognostic variables in adult patients who admitted to intensive care unit (ICU). Material and Methods: Patients with HM who were hospitalized in the ICU for more than 24 hours between 2010 and 2018 were retrospectively analyzed. Patients were compared in terms of factors effecting the mortality. Results: The mortality rate of 99 HM patients who were inclueded in the study was 86%. APACHE II and SOFA scores and the need for invasive mechanical ventilation and vasopressor treatment during ICU hospitalizations were significiantly high in exitus group (p<0.05). It was seen that the type of HM did not make any difference on mortality (p<0.05). Conclusion: Mortality is high in critically ill patients with HM and it is seen that the need for vasopressor support is influential especially during admission to ICU.
Keywords: Critical care; mortality; hematologic malignancies
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