Postoperatif cerrahi onkoloji hastalarında APACHE II, SAPS II skorlama sistemleri ve CRP albümin oranının prognozu öngörmedeki rolleri
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
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Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada, 2019-2023 yılları arasında gastrointestinal sistem malignitesi nedeniyle ameliyat edilen ve postoperatif yoğun bakım ünitesine yatırılan 158 hastanın kayıtları incelenerek, APACHE II, SAPS II skorlama sistemleri ve CRP/Albümin oranının prognozu öngörmedeki rolleri değerlendirilmiştir. Hastaların demografik verileri, ek hastalık varlığı, ek rezeksiyon durumu gibi faktörler dikkate alınarak hastalar; exitus, yoğun bakım ünitesi yatış süresi ve toplam postoperatif hastane yatış süresi olmak üzere 3 ana gruba ayrılmıştır. Exitus olan grupta; yaş, yoğun bakım ünitesi yatış süresi, 2. yoğun bakım ünitesi yatışı, ek rezeksiyon varlığı, ilk 24 saat mekanik ventilasyon ihtiyacının devam etmesi, APACHE II ve SAPS II skorları anlamlı yüksek bulunmuştur. Yoğun bakım ünitesi yatış süresi >3 gün olan grupta ise ek hastalık oranı, 2. yoğun bakım ünitesi yatışı, ek rezeksiyon varlığı, mekanik ventilasyon ihtiyacının devamı, exitus oranı, APACHE II ve SAPS II skorları anlamlı yüksek saptanmıştır. Toplam postoperatif hastane yatış süresi >14 gün olan grupta yaş, ek rezeksiyon oranı, preoperatif hastanede kalış süresi, 2. yoğun bakım ünitesi yatışı ve yoğun bakım ünitesi yatış süresi >3 gün olanların oranı anlamlı yüksek bulunmuştur. Öte yandan CRP, albümin ve CRP/Albümin oranının prognozla ilişkili olmadığı görülmüştür. Sonuç olarak, bu spesifik hasta grubunda APACHE II ve SAPS II skorlama sistemlerinin prognozu öngörmede etkili olduğu, ancak CRP/Albümin oranının prognoz belirleyici bir gösterge olmadığı saptanmıştır. Çalışmamız, cerrahi onkoloji hastalarında skorlama sistemlerinin prognostik değerinin yanı sıra hastaların genel durumunu ve komplikasyon risklerini değerlendirmede önemli bir rehber olabileceğini ortaya koymuştur.
In this study, the records of 158 patients who were operated on due to gastrointestinal tract malignancy between 2019-2023 and were admitted to the postoperative intensive care unit were examined, and the role of APACHE II, SAPS II scoring systems and CRP/Albumin ratio in predicting the prognosis were evaluated. Taking into account factors such as the demographic data of the patients, the presence of additional disease, additional resection status, the patients were divided into 3 main groups as exitus, intensive care unit hospitalization period and total postoperative hospital hospitalization period. In the group with exitus; age, intensive care unit hospitalization time, 2nd intensive care unit hospitalization, presence of additional resection, continuation of the need for mechanical ventilation for the first 24 hours, APACHE II and SAPS II scores were found to be significantly higher. In the group with an intensive care unit hospitalization period of >3 days, additional disease rate, 2nd intensive care unit hospitalization, presence of additional resection, continuation of mechanical ventilation need, exitus rate, APACHE II and SAPS II scores were significantly high. In the group with a total postoperative hospital hospitalization period of >14 days, the rate of age, additional resection, duration of preoperative hospital stay, 2nd intensive care unit hospitalization and intensive care unit hospitalization period >3 days was significantly higher. On the other hand, the CRP, albumin and CRP/Albumin ratio were not associated with the prognosis. As a result, it was found that the APACHE II and SAPS II scoring systems in this specific patient group were effective in predicting the prognosis, but the CRP/Albumin ratio was not a prognosis-determining indicator. Our study found that scoring systems in surgical oncology patients can be an important guide in assessing the prognostic value of patients as well as their general condition and complication risks.
In this study, the records of 158 patients who were operated on due to gastrointestinal tract malignancy between 2019-2023 and were admitted to the postoperative intensive care unit were examined, and the role of APACHE II, SAPS II scoring systems and CRP/Albumin ratio in predicting the prognosis were evaluated. Taking into account factors such as the demographic data of the patients, the presence of additional disease, additional resection status, the patients were divided into 3 main groups as exitus, intensive care unit hospitalization period and total postoperative hospital hospitalization period. In the group with exitus; age, intensive care unit hospitalization time, 2nd intensive care unit hospitalization, presence of additional resection, continuation of the need for mechanical ventilation for the first 24 hours, APACHE II and SAPS II scores were found to be significantly higher. In the group with an intensive care unit hospitalization period of >3 days, additional disease rate, 2nd intensive care unit hospitalization, presence of additional resection, continuation of mechanical ventilation need, exitus rate, APACHE II and SAPS II scores were significantly high. In the group with a total postoperative hospital hospitalization period of >14 days, the rate of age, additional resection, duration of preoperative hospital stay, 2nd intensive care unit hospitalization and intensive care unit hospitalization period >3 days was significantly higher. On the other hand, the CRP, albumin and CRP/Albumin ratio were not associated with the prognosis. As a result, it was found that the APACHE II and SAPS II scoring systems in this specific patient group were effective in predicting the prognosis, but the CRP/Albumin ratio was not a prognosis-determining indicator. Our study found that scoring systems in surgical oncology patients can be an important guide in assessing the prognostic value of patients as well as their general condition and complication risks.
Açıklama
Tıp Fakültesi, Genel Cerrahi Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation ; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji
