Original Article / Özgün Araştırma 162 Amaç: Koroner baypas (KABG) ameliyatları sonrasında yeniden yoğun bakım ünitesine (YBÜ) yatış belli bir oranda görülür ve seyri kötüdür. Bu çalışmada tek merkezde KABG uygulanmış hastalarda yeniden YBÜ'ne yatış risk faktörleri analiz edilmiştir.Yöntemler: Tek bir merkezde koroner baypas ameliyatına alı-nan 679 hastanın prospektif olarak toplanan verileri, yeniden YBÜ'ne yatış risk faktörlerinin değerlendirilmesi için retrospektif olarak lojistik regresyon analizi ile incelendi. Yeniden YBÜ'ne yatış ihtiyacı olan hastalar (Grup R) ile diğerleri (Grup N) karşılaştırıldı. Bulgular:Otuz altı hasta (%5,3) yeniden YBÜ'ne yatırıldı. Postoperatif hastane mortalitesi, pulmoner ve nörolojik morbidite sırasıyla 43 (%6,3), 135 (%19,9 ve 46 (%6,8) hastada görüldü. Grupların karşılaştırmasında mortalite ve morbiditenin Grup R'de Grup N'ye göre anlamlı olarak daha yüksek olduğu görüldü (mortalite %16,7'ye karşı %5,9, p=0,029; pulmoner morbidite %66,7'ye karşı %17,3, p=0,0001; nörolojik morbidite %38,9'a karşı %5,0, p=0,0001). Yeniden YBÜ'ne yatış ile anlamlı ilişki-si olan faktörler ameliyat öncesi sol ventrikül işlev bozukluğu olması (Odds oranı (OR)=4,1; %95 güvenlik aralığı (CI)=1,4-12,5; p=0,013), ileri NYHA sınıfı (OR=5,3; %95 CI=1,3-21,7; p=0,022), pulmoner komplikasyonlar (OR=7,3; %95 CI=2,1-25,5; p=0,002) ve nörolojik komplikasyonlar (OR=4,6; %95 CI=1,3-16,7; p=0,021) idi.Sonuç: KABG sonrası yeniden YBÜ'ne yatırılan hastalarda daha yüksek oranda mortalite, pulmoner ve nörolojik komplikasyonlar görülmektedir. Sol ventrikül işlev bozukluğu, ileri NYHA sınıfı ve postoperatif pulmoner ve nörolojik komplikasyon görülmesi yeniden YBÜ'ne yatış için anlamlı risk faktörleridir.Anahtar Kelimeler: Koroner arter baypas, yoğun bakım ünitesi, yeniden yatış, risk faktörü Objective: Intensive care unit (ICU) readmissions after coronary bypass (CABG) operations occur in a significant number of patients, and the prognosis is poor. We analyzed the risk factors for ICU readmissions after CABG operations in a single institution. Methods:We retrospectively analyzed the prospectively collected data of 679 coronary bypass patients operated in a single institution in order to evaluate the risk factors for readmittance to the ICU with logistic regression analysis. The outcome results of patients readmitted to the ICU (Group R) and others (Group N) were compared.Results: Thirty-six (5.3%) patients were readmitted to the ICU. Postoperative in-hospital mortality and pulmonary and neurologic morbidity occurred in 43 (6.3%), 135 (19.9%), and 46 (6.8%) patients, respectively. The comparison of groups showed that mortality and morbidity were significantly higher in Group R compared to Group N (mortality 16.7% vs. 5.9, p=0.029; pulmonary morbidity 66.7% vs. 17.3%, p=0.0001; neurologic morbidity 38.9% vs. 5.0%, p=0.0001). Features associated with readmission included presence of left ventricular dysfunction preoperatively[odds ratio (OR)=4.1; 95% confidence interval (CI)=1.4-12.5; p=0.013], advanced NYHA Class (OR=...
Objective: The aim of this study was to discuss the risk factors and frequency associated with pressure ulcer (PU) development in intensive care units (ICU). Materials and Methods: A retrospective analysis of patients with PU admitted to the 25-bed ICU on January 1 2016-2017 was carried out. Patients who were in intensive care for more than 48 hours were included in the study. Patients were evaluated in terms of demographic data of pressure ulcers in intensive care unit, number of days in intensive care unit, Acute Physiology and Chronic Health Evaluation II score, primary diagnoses, days of pressure ulcer development, number of days of mechanical ventilation and wound infections and ulcer pressures. Results: In follow-up with the Norton risk assessment scale, 25 patient of 1625 patients accepted intensive care developed a pressure ulcer (1.5%). Pressure Ulceration day was found to be 16.5 days from hospitalization. Twenty of 25 patients were treated with wet dressing (Phase II). The most common pathogens in PU infections were Acinetobacter baumanii (in 3 patients) and MRSA (in 2 patients). Sacrum and coccyx were the common areas of pressure sores. Conclusion: Pressure ulcers are an important problem for intensive care and elderly patients. In these patients, initial applications should be primarily to prevent the development of PU, because risk assessment and prevention efforts may prevent the formation and progression.
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