KLİNİĞİMİZDE YETİŞKİN HASTALARA UYGULANAN SPİNAL CERRAHİLER SONRASI GELİŞEN PULMONER EMBOLİ İNSİDANSI

Year 2024, Volume: 25 Issue: 1 - OCAK 2024 SAYISI, 43 - 47, 17.01.2024

İhsan Canbek , Serhat Yıldızhan , Mehmet Gazi Boyacı , Usame Rakip , Serhat Korkmaz , Adem Aslan , Havva Hafize Talaz , Hayriye Nur Sarıkaş , İrem Günarslan , Abdulsalam Souda , Metra Sharifi

https://doi.org/10.18229/kocatepetip.1186850

Abstract

AMAÇ: Bu çalışmanın amacı farklı nedenlerle spinal cerrahi girişim geçirmiş hastalarda pulmoner emboli (PE) insidansını belirlemek olup cerrahi etyolojinin insidansa etkisinin olup olmadığını araştırmaktır.
GEREÇ VE YÖNTEM: 01.01.2017 - 30.11.2021 tarihleri arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi Hastanesi’nde spinal cerrahi uygulanan hastalarda post-op gelişen PE komplikasyonunu değerlendirmek için Hastane Bilgi Yönetim Sistemi (HBYS) kayıtları, ameliyatların International Classification of Disease (ICD) kodları kullanılarak retrospektif olarak gözden geçirildi. Çalışmaya 18-64 yaş aralığındaki hastaların verileri dahil edildi. Çocuklar ve 65 yaş üzeri hastalar çalışma dışı bırakıldı. PE saptanan hastaların verileri PE için potansiyel risk faktörlerini değerlendirmek amacıyla analiz edildi. İstatistiksel analiz için Fisher-Freeman-Halton Exact Test ile ki kare testi uygulandı.
BULGULAR: 581’i kadın (%52,6), 524’ü erkek(%47,4) olmak üzere toplam 1105 hasta dosyası retrospektif olarak tarandı. Stabilizasyon uygulanmış dejenerasyon grubunda 382 (%34,6), travma grubunda 291 (%26,3), stabilizasyon uygulanmamış dejenerasyon grubunda 287 (%26), tümör grubunda 86 (%7,8), enfeksiyon grubunda 59 (%5,3) hasta vardı. İncelenen 1105 hastanın 6’sında PE komplikasyonu görüldü. Bu çalışmada PE insidansı %0,54’tür. PE saptanan 6 hastanın 3’ü erkek (%50), 3’ü kadındı (%50). Erkeklerin tümü travma nedeniyle opere edilirken; kadınların 1’i travma, 1’i tümör, 1’i de enfeksiyon nedeniyle opere edildi. Gruplar arasında istatistiksel anlamlı fark saptandı (p= 0,014). Tümör ve enfeksiyon nedeniyle opere edilen 2 kadın hasta ilerleyen süreçte hayatını kaybetti . Böylece PE görülenlerde mortalite oranı %33,3 olarak bulundu.
SONUÇ: PE nadir görülmekle birlikte çok ciddi klinik sonuçları olan mortalitesi yüksek bir komplikasyondur.

Keywords

Spinal cerrahi, Pulmoner embolizm, İnsidans

Supporting Institution

herhangi finansal destek alınmadı

INCIDENCE OF PULMONARY EMBOLISM DEVELOPING AFTER SPINAL SURGERIES APPLIED TO ADULT PATIENTS IN OUR CLINIC

Abstract

OBJECTIVE: The aims of this study are to determine the incidence of pulmonary embolism (PE) in patients who have undergone spinal surgery for different reasons and to investigate whether the surgical etiology has an effect on the incidence.
MATERIAL AND METHODS: Hospital Information Management System (HIMS) records were reviewed retrospectively using ICD (International Classification of Disease) codes of surgeries to evaluate post-operative PE complications in patients who underwent spinal surgery at Afyonkarahisar Health Sciences University Hospital between 01.01.2017 - 30.11.2021. Data of patients aged 18-64 years were included in the study. Patients over 65 years of age and children were excluded from the study. Data of patients with PE were analyzed to evaluate potential risk factors for PE. Chi-square test with Fisher-Freeman-Halton Exact Test was used for statistical analysis.
RESULTS: A total of 1105 patient files, 581 women (52.6%) and 524 men (47.4%), were reviewed retrospectively. 382 (34.6%) in the stabilized degeneration group, 291 (26.3%) in the trauma group, 287 (26%) in the unstabilized degeneration group, 86 (7.8%) in the tumor group, 59 (5.3%) in the infection group) were sick. PE complications seen in 6 of 1105 patients were examined. The incidence of PE in this study was 0.54%. Of the 6 patients with PE, 3 were male (50%) and 3 were female (50%). One of the women was operated for trauma, one for tumor, and one for infection. A statistically significant difference was found between the groups (p: 0.014). Two female patients who were operated on due to tumor and infection died in the following period. Thus, the mortality rate in patients with PE was found to be 33.3%.
CONCLUSIONS: Although PE is rare, it is a complication with very serious clinical consequences and a high mortality.

Keywords

Spinal surgery, Pulmonary embolism, Incidence

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