Acil Servise Başvuran Hastalarda Post Operatif Komplikasyonların Epidemiyolojik İncelenmesi

Year 2018, Volume: 8 Issue: 2, 103 - 110, 17.05.2018

İlyas Koç Mehmet Esen

https://doi.org/10.16899/gopctd.412029

Abstract

Amaç: Bu çalışmanın amacı postoperatif
komplikasyonlara bağlı olarak planlanmamış acil servis ziyaretlerinin değerlendirilmesidir.
Bu çalışmada  postoperatif
komplikasyonlara bağlı klinik ve laboratuvar nedenler ve görülme oranlarını
belirlendi.

Gereç ve Yöntem: Bu prospektif çalışmaya, Mayıs 2014
ve Nisan 2015 döneminde, postoperatif komplikasyonlar nedeniyle Gaziosmanpaşa
Üniversitesi Tıp Fakültesi Hastanesi Acil Servisine başvuran 640 hastanın 300'ü
dahil edildi. Veriler SPSS ortamında kaydedildi. Niteliksel veriler Ki-kare
testleri kullanılarak analiz edildi. Nicel veriler, tek yönlü varyans analizi
kullanılarak analiz edildi. Çoklu karşılaştırma için Tukey testi kullanıldı.

Sonuçlar: Planlanmamış yeniden kabul oranı, ülke
çapında hastane bakım sonuçları ölçütüdür. Acil servisimize başvuran toplam
11755 hastadan 640'ı postoperatif komplikasyonlar için başvurdu. Tekrar operasyona
alınma;  ileri yaş, yüksek ortalama arter
basıncı ve tekrarlayan acil geri kabul ile ilişkilidir. Ameliyat sonrası
komplikasyonlar nedeniyle acil servise birden çok başvuran bu grupta, ortalama
CRP değeri anlamlı olarak yüksek bulundu. Bu hastalarda yara yeri enfeksiyonları
(% 20.3), hemoraji-hematom (% 10) ve pulmoner emboli (% 2,33) vardı. Bu
durumlar için insidans oranları literatürde bildirilen oranlardan daha
yüksekti.

Sonuçlar: İlşeri yaş, komplikasyonlu hastalıklar,
artmış CRP ve uzun yatışları olan hastalar, gelişebilecek komplikasyonlar
hakkında bilgilendirildikten sonra hastaneden taburcu edilmeli. Yüksek
morbidite ve mortalite oranlarından dolayı tekrarlayan başvuruları olan
hastalara acil bakım dikkatle verilmelidir. Gerekli önlemlerin alınması hem
maliyet hem de acil servis ziyaretlerinin sayısını önemli ölçüde azaltacaktır.

Keywords

acil servis, postoperatif komplikasyon, tekrar başvuru

Epidemiology of post-operative complications in patients admitted to emergency service

Abstract

Aim: The aim of this study was to
evaluate unplanned emergency room visits due to postoperative complications.The present study was to determine incidence rates of and
clinic and laboratory causes of readmissions due to postoperative complications.

Materials and Methods: This prospective study included 300 of 640 patients
who presented to Emergency Service of Gaziosmanpaşa University, Faculty of
Medicine Hospital due to postoperative complications in May 2014 and April 2015
period. The data were recorded in the SPSS environment. Qualitative data were
analyzed using Chi-square tests. Quantitative data were analyzed using one-way
analysis of variance. Tukey test was used for multiple comparisons.

Results: The unplanned readmission rate is a nation-wide measure of hospital
care outcomes. Of all 11,755 patients presenting to our emergency department,
640 applied for postoperative complications. Re-operation is associated with
older age, high mean arterial pressure and recurrent emergency readmission. Average
CRP was significantly higher in this group of patients admitted to the emergency
service with postoperative complications for reoperation. These patients had
wound infections (20.3%), hemorrhage-hematoma (10%) and pulmonary embolism
(2.33%). The incidence rates for these conditions were higher than the rates
reported in literature.

Conclusions: Patients with old age, comorbid diseases, elevated
CRP and long hospitalizations should be discharged from hospital after they
have been informed about the complications that may develop. Emergency care
should be given more carefully to patients with recurrent readmissions because
of their high morbidity and mortality rates. Taking necessary precautions will
significantly reduce both cost and number of emergency service visits.

Keywords

postoperative complication, emergency service, readmission

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