Dispne ile başvuran geriyatrik olgularda yakınma şiddeti ile klinik ve laboratuvar verilerinin değerlendirilmesi
Küçük Resim Yok
Tarih
2009
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Acil servise başvurularda önemli bir yer kaplayan geriyatrik olgularda nefes darlığının hasta ve hekim tarafından algılanan şiddetinin prognostik ve laboratuvar parametrelerle ilişkisi çalışmalarla net olarak ortaya konmamıştır. Çalışmamızda acil servise nefes darlığı yakınması ile başvuran geriyatrik hastalarda nefes darlığı şiddetinin laboratuvar ve klinik parametrelerle korelasyonunun belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Acil servise dispne yakınmasıyla başvuran 65 yaş üzeri ardışık hastalar çalışmaya alındı. Hastalar dispne şiddetini belirlemek amacıyla 100 mm’lik vizüel analog skala (VAS) ve 12 değişkenli Borg skorlaması üzerinde işaretleme yaptılar. Benzer şekilde acil tıp hekimleri dispnenin şiddetini 100 mm’lik VAS ve Medical Research Council (MRC) skorlaması üzerinden değerlendirdi. Hastaların VAS, Borg ve MRC skorları ile belirlenen dispne yakınmalarının demografik parametreler, klinik ve laboratuvar verileriyle ilişkisi araştırıldı. Bulgular: Çalışmaya alınan 181 hastanın VAS ortalaması 65.4±27.7 mm idi. VAS değerleri yaş ve cinsiyetten bağımsızken, SaO2 (p=0.040), PaCO2 (p=0.010), pH (p=0.020) düzeyi ve solunum sayısı (p=0.000) ile aralarında anlamlı ilişki saptandı. Hekim VAS ortalaması 50.5±26.2 mm olarak bulundu ve benzer şekilde hekim VAS değeri ile SpO2 (p=0.006), SaO2 (p=0.001), pH düzeyi (p=0.000), PEF değeri (p=0.000) ve solunum sayısı (p=0.006) arasında da anlamlı ilişki saptandı. Hastaların MRC skorları ile PaCO2 (p=0.017), pH (p=0.002), PaO2 (p=0.012), SaO2 (p=0.002), SpO2 (p=0.000) düzeyleri, PEF değerleri (p=0.001) ve solunum sayıları (p=0.001) arasındaki ilişki anlamlıydı. Benzer şekilde Borg skorları ile SaO2 (p=0.000), PaO2 (p=0.000), PaCO2 (p=0.014) düzeyleri, PEF (p=0.045) değerleri ve solunum sayısı (p=0.000) arasındaki ilişki de anlamlıydı. Borg ve MRC skorları da yaş ve cinsiyet bağımsızdı. Hasta VAS’ı ile hekim VAS’ı (?=0.49, p=0.000), Borg (?=0.77, p=0.000) ve MRC (?=0.23, p=0.030) skorlaması arasında korelasyon bulundu. Hekim VAS’ı ile MRC (?=0.41, p=0.000) ve Borg (?=0.58, p=0.000) skorlaması arasında ve MRC ile Borg (?=0.306, p=0.000) skorlaması arasında da anlamlı korelasyon bulundu. Sonuç: Acil servise dispne şikayeti ile başvuran geriyatrik olgularda dispne şiddetini değerlendirmede VAS, Borg ve MRC skalaları güvenle kullanılabilir. Her üç skala da laboratuvar ve klinik verilerle ve birbirleriyle ilişkilidir.
Objective: There is insufficient data in the literature concerning the correlation between clinical and laboratory variables and the severity of dyspnea as perceived by the patient and the physician. the objective of this study is to investigate the correlation of dyspnea ratings with laboratory and clinical variables in elderly patients in the emergency department (ED). Methods: the study involved all geriatric patients consecutively admitted in the ED with dyspnea uring th study period. Patients marked the severity of dyspnea using 100-mm VAS and Borg scales. Emergency physicians marked their estimates of dyspnea severity on Visual Analog Scale (VAS) and Medical Research Council Dyspne Scale (MRC). Correlation among the patients‘ VAS, Borg and MRC scores and demografic patterns, clinical and laboratory findings was studied. Results: Mean VAS score of the eligible patients (n=181) was 65.4 mm. VAS scores rated by the patients themselves was found to be significantly related to SaO2 (p=0.040), PaCO2 (p=0.010), pH (p=0.020) and respiratory rate (p=0.000) while unrelated to age, sex, level of education. Mean VAS score revealed by physicians was 50.5 mm and had significant relation with SaO2 (p=0.001), SpO2 (p=0.006), pH (p=0.000) and respiratory rate (p=0.006). MRC scores were found to be related to SaO2 (p=0.002), PaCO2 (p=0.017), pH (p=0.002), PaO2 (p=0.012), SpO2 (p=0.000), PEF (p=0.006) and respiratory rate (p=0.010) while Borg scores had significant relation with SaO2 (p=0.000), PaCO2 (p=0.014), PaO2 (p=0.000), PEF (p=0.045) and respiratory rate (p=0.000). VAS markings by patients was correlated with VAS rating by physicians (ρ=0.49, p=0.000), MRC (ρ=0.23, p=0.030), Borg scores (ρ=0.77, p=0.000). VAS rating by physicians was also correlated with MRC (ρ=0.41, p=0.000) and Borg scores (ρ=0.58, p=0.000). MRC scores with Borg scores (ρ=0.306, p=0.000) was significantly correlated. Conclusions: VAS, Borg and MRC scales were used to indicate estimates of dyspnea severity of the patients in the ED correlates well with clinical and laboratory findings and could be viewed as a reliable guide in the management of elderly patients with dyspnea.
Objective: There is insufficient data in the literature concerning the correlation between clinical and laboratory variables and the severity of dyspnea as perceived by the patient and the physician. the objective of this study is to investigate the correlation of dyspnea ratings with laboratory and clinical variables in elderly patients in the emergency department (ED). Methods: the study involved all geriatric patients consecutively admitted in the ED with dyspnea uring th study period. Patients marked the severity of dyspnea using 100-mm VAS and Borg scales. Emergency physicians marked their estimates of dyspnea severity on Visual Analog Scale (VAS) and Medical Research Council Dyspne Scale (MRC). Correlation among the patients‘ VAS, Borg and MRC scores and demografic patterns, clinical and laboratory findings was studied. Results: Mean VAS score of the eligible patients (n=181) was 65.4 mm. VAS scores rated by the patients themselves was found to be significantly related to SaO2 (p=0.040), PaCO2 (p=0.010), pH (p=0.020) and respiratory rate (p=0.000) while unrelated to age, sex, level of education. Mean VAS score revealed by physicians was 50.5 mm and had significant relation with SaO2 (p=0.001), SpO2 (p=0.006), pH (p=0.000) and respiratory rate (p=0.006). MRC scores were found to be related to SaO2 (p=0.002), PaCO2 (p=0.017), pH (p=0.002), PaO2 (p=0.012), SpO2 (p=0.000), PEF (p=0.006) and respiratory rate (p=0.010) while Borg scores had significant relation with SaO2 (p=0.000), PaCO2 (p=0.014), PaO2 (p=0.000), PEF (p=0.045) and respiratory rate (p=0.000). VAS markings by patients was correlated with VAS rating by physicians (ρ=0.49, p=0.000), MRC (ρ=0.23, p=0.030), Borg scores (ρ=0.77, p=0.000). VAS rating by physicians was also correlated with MRC (ρ=0.41, p=0.000) and Borg scores (ρ=0.58, p=0.000). MRC scores with Borg scores (ρ=0.306, p=0.000) was significantly correlated. Conclusions: VAS, Borg and MRC scales were used to indicate estimates of dyspnea severity of the patients in the ED correlates well with clinical and laboratory findings and could be viewed as a reliable guide in the management of elderly patients with dyspnea.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türkiye Acil Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
4
