Yoğun bakım ünitesindeki geriatrik hastalarda prognostik ve organ yetmezliği skorlama sistemleri ile nütrisyon skorları arasındaki ilişki

Year 2021, Volume: 2 Issue: 3, 107 - 111, 30.12.2021

Ridvan Sivritepe , Sema Uçak Basat , Okcan Basat , Oğuzhan Kara , Damla Ortaboz , Ecem Sevim , Arzu Baygül

https://doi.org/10.29228/anatoljhr.52893

Abstract

Amaç: Bu çalışmada yoğun bakım ünitesindeki (YBÜ) geriatrik hastalarda gibi prognostik skorlama sistemleri ile nütrisyon skorları arasındaki ilişki araştırıldı.
Yöntem: Kesitsel-prospektif olan bu çalışmaya YBÜ’ye interne edilen 45 geriatrik hasta dahil edildi. Hastaların fiziki muayeneleri yapılıp kan tetkikleri analiz edildi. Nutrisyon durumu Mini Beslenme Değerlendirmesi (MNA) ve Beslenme Riski Taraması 2002 (NRS2002) ile değerlendirildi. Hastaların Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II (APACHEII), Basitleştirilmiş Akut Fizyoloji Skoru II (SAPSII), Çoklu Organ Disfonksiyon Skoru (MODS), Ardışık Organ Yetmezliği Değerlendirmesi (SOFA) ve Glasgow Koma Skorları (GKS) hesaplandı. Hastalar nutrisyon durumlarına göre normal, malnütrisyon riski altında ve malnütre olacak şekilde, prognostik skorlarına göre ise yüksek-riskli ve düşük-riskli diye gruplara ayrıldı. p<0.05 olarak kabul edildi..
Bulgular: MNA skoruna göre 45 hastanın 18’inde malnütrisyon ve 22’sinde malnütrisyon riski varken iken yalnızca 5 hasta normal nütrisyon durumundaydı. NRS2002’ye göre ise tüm hastalar malnütrisyon riski altındaydı. MNA göre malnütrisyon riski altında olan ve malnütrisyonlu grup arasında SAPSII ve GKS skoru açısından farklılık saptandı (p=0.033; p=0.040). APACHEII ve SAPSII skoruna göre yüksek riskli olan grupta NRS2002 skoru anlamlı olarak daha yüksekti (p=0.012; p=0.021). MNA ile SAPSII ve MODS arasında negatif, MNA ile GKS arasında ise pozitif korelasyon tespit edildi. NRS2002 ile APACHEII, SAPSII, MODS, SOFA arasında pozitif ve NRS2002 ile GKS ile arasında negatif korelasyon saptandı.
Sonuçlar: Çalışmamız malnütrisyonun yoğun bakımda yatan hastalarda organ yetmezliği ve prognoz üzerine önemli bir etkiye sahip olabileceğini göstermiştir.

Keywords

APACHE, beslenme değerlendirmesi, malnütrisyon, organ bozukluğu skorları, yaşlanma, yoğun bakım ünitesi

The relationship between prognostic and organ failure scoring systems and nutritional scores in geriatric patients in intensive care unit

Abstract

Aim: The relationship between prognostic and organ failure scoring systems and nutritional scores was investigated in geriatric patients in the intensive care unit (ICU).
Methods: This cross-sectional study included 45 geriatric patients who were admitted to the ICU. Physical examinations were performed, and blood tests were analysed. Nutritional status was assessed by Mini Nutritional Assessment (MNA) and Nutritional Risk Screening 2002 (NRS2002). Acute Physiology and Chronic Health Evaluation II (APACHEII), Simplified Acute Physiology Score (SAPSII), Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) of patients were calculated. The patients were divided into groups as normal nutrition status, at risk of malnutrition and malnourished according to nutritional status, and high-risk and low-risk according to prognostic scores. Significance was accepted as p<0.05.
Results: According to the MNA score, 18 of 45 patients had malnutrition and 22 had malnutrition risk, while only 5 patients had normal nutrition status. According to NRS2002, all patients were at risk of malnutrition. There was a difference in SAPSII and GCS scores between the malnourished group and those at risk of malnutrition according to MNA (p=0.033;p=0.040). NRS2002 score was significantly higher in the high-risk group according to the APACHEII and SAPSII score (p=0.012;p=0.021). There was negative correlation between MNA and SAPSII and MODS, and positive correlation between MNA and GCS. There was positive correlation between NRS2002 and APACHEII, SAPSII, MODS, SOFA.
Conclusion: We found that malnutrition can have a significant impact on organ failure and prognosis in patients hospitalized in ICU.

Keywords

aged, APACHE, ıntensive care units, malnutrition, nutrition assessment, organ dysfunction scores

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