Yoğun Bakımda Yatan Palyatif Hasta İnsidansı
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Yoğun bakım ünitelerinde pek çok hastanın palyatif bakım hastası olduğu bilinmektedir. Araştırmamızda, Trakya Trakya Üniversitesi Tıp Fakültesi'nde bulunan 11 yataklı Cerrahi Yoğun Bakım Ünitesi ve 6 yataklı Reanimasyon Yoğun Bakım Ünitesinde yatışı olan palyatif bakım hastalarını saptamayı hedefledik. Çeşitli parametreler çerçevesinde hastaların özelliklerini ortaya koyduk. Araştırmamıza 140 hasta dahil edildi. Hastaların %57,8'i erkekti. Yaş ortalaması 68,85 bulundu. Ağırlık ortalaması 74,7 kg idi. Hastaların %44,3'ünün yatış nedeni serebral patoloji, %27,1'inin terminal dönem kanser, %13,6'sının akciğer patolojisi, %9,3'ünün basınç yarası, %5,7'sinin malnütrisyon olarak saptandı. APACHE II ortalaması 21,6, SOFA ortalaması 6,69, Palyatif Prognostik İndeks ortalaması 9,75, hastaların yarısından fazlasında Palyatif Performans Skalası %20, hastaların %22,9'unda Karnofsky Skoru 30 ve %20'sinde 20 bulundu. Hastaların %75,7'sinde ECOG Performans Skoru 4 tespit edildi. Yoğun bakım sürecinde operasyona alınma oranı %23,6 bulundu. Renal replasman tedavisi oranı %29,3, pozitif inotrop tedavisi oranı %82,9, trakeostomi oranı %55 tespit edildi. Hastaların yoğun bakımda yatış süresi ortalama 37,48 gündü. Hastaların %80'inin yoğun bakımda ilk yatışta vefat ettiği gözlendi. Taburcu hastaların ise %92,9'unun yeniden yatış yaptığı görüldü. Serebral patoloji hastalarında exitus oranı daha yüksek bulundu. Ayrıca ölen hastalarda APACHE II, SOFA ve Palyatif Prognostik İndeks skoru daha yüksekti. Palyatif Performans Skalasında %20 grubunda bulunan hastalarda ölüm oranı daha fazlaydı. Vefat edenlerin en fazla 20 Karnofsky Skoru ve 4 ECOG Skoru grubunda olduğu görüldü. Hastaların ortalama yoğun bakım yatış maliyetleri 86.557,41 TL idi. Günlük ortalama maliyet ise 3.177,19 TL olarak saptandı. Araştırma sonuçlarımız yoğun bakımda palyatif hasta insidansının yüksek olduğunu göstermektedir. Bu bakımdan hasta bakım ihtiyacının giderilmesi ve maliyetin düşürülebilmesi için palyatif bakım servislerinin artırılması gerektiği anlaşılmıştır.
In intensive care units, it is known that many patients require palliative care. In our study, we aimed to identify palliative care patients admitted to the 11-bed Surgical Intensive Care Unit and the 6-bed Reanimation Intensive Care Unit at Trakya University Faculty of Medicine. We delineated the characteristics of patients based on various parameters. A total of 140 patients were included in our study. 57.8% of the patients were male. The average age was found to be 68.85. The average weight was 74.7 kg. The reasons for admission were determined as cerebral pathology in 44.3% of patients, terminal stage cancer in 27.1%, lung pathology in 13.6%, pressure ulcers in 9.3%, and malnutrition in 5.7%. The average APACHE II score was 21.6, the average SOFA score was 6.69, the average Palliative Prognostic Index was 9.75, and more than half of the patients had a Palliative Performance Scale of 20%. The Karnofsky Score was 30 in 22.9% of patients and 20 in 20% of patients. An ECOG Performance Score of 4 was found in 75.7% of patients. The rate of undergoing surgery during the intensive care process was 23.6%. The rates of renal replacement therapy, positive inotrope therapy, and tracheostomy were 29.3%, 82.9%, and 55%, respectively. The average length of stay in the intensive care unit for patients was 37.48 days. 80% of the patients had an ex at their first admission to the intensive care unit. Among discharged patients, 92.9% were readmitted. Patients with cerebral pathology had a higher ex rate. Additionally, in ex patients, the APACHE II, SOFA, and palliative Prognostic Index scores were higher. Patients in the 20% group of the Palliative Performance Scale had a higher ex rate. Those with an ex had the highest incidence of 20 Karnofsky Score and 4 ECOG Score. The average cost of intensive care unit admission for patients was 86,557.41 Turkish Lira(TL). The daily average cost was determined to be 3,177.19 TL. Our research results indicate a high incidence of palliative patients in the intensive care unit. Therefore, it is understood that there is a need to increase palliative care services to meet patient care needs and reduce costs.
In intensive care units, it is known that many patients require palliative care. In our study, we aimed to identify palliative care patients admitted to the 11-bed Surgical Intensive Care Unit and the 6-bed Reanimation Intensive Care Unit at Trakya University Faculty of Medicine. We delineated the characteristics of patients based on various parameters. A total of 140 patients were included in our study. 57.8% of the patients were male. The average age was found to be 68.85. The average weight was 74.7 kg. The reasons for admission were determined as cerebral pathology in 44.3% of patients, terminal stage cancer in 27.1%, lung pathology in 13.6%, pressure ulcers in 9.3%, and malnutrition in 5.7%. The average APACHE II score was 21.6, the average SOFA score was 6.69, the average Palliative Prognostic Index was 9.75, and more than half of the patients had a Palliative Performance Scale of 20%. The Karnofsky Score was 30 in 22.9% of patients and 20 in 20% of patients. An ECOG Performance Score of 4 was found in 75.7% of patients. The rate of undergoing surgery during the intensive care process was 23.6%. The rates of renal replacement therapy, positive inotrope therapy, and tracheostomy were 29.3%, 82.9%, and 55%, respectively. The average length of stay in the intensive care unit for patients was 37.48 days. 80% of the patients had an ex at their first admission to the intensive care unit. Among discharged patients, 92.9% were readmitted. Patients with cerebral pathology had a higher ex rate. Additionally, in ex patients, the APACHE II, SOFA, and palliative Prognostic Index scores were higher. Patients in the 20% group of the Palliative Performance Scale had a higher ex rate. Those with an ex had the highest incidence of 20 Karnofsky Score and 4 ECOG Score. The average cost of intensive care unit admission for patients was 86,557.41 Turkish Lira(TL). The daily average cost was determined to be 3,177.19 TL. Our research results indicate a high incidence of palliative patients in the intensive care unit. Therefore, it is understood that there is a need to increase palliative care services to meet patient care needs and reduce costs.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
