İç Hastalıkları Kliniğinde Tedavi Edilen Geriatrik Hastaların Değerlendirilmesi

Year 2021, Volume: 11 Issue: 3, 507 - 515, 22.09.2021

Türkan Paşalı Kilit , Kevser Onbaşı , Aydan Akalın

https://doi.org/10.31832/smj.927899

Cited By: 1

Abstract

Amaç: İç Hastalıkları Kliniğinde tedavi gören geriatrik hastaların demografik özelliklerini, hastaneye yatış nedenlerini, kronik hastalıklarını ve laboratuvar sonuçlarını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Çalışmaya Ocak 2015 ile Aralık 2017 tarihleri arasında İç Hastalıkları Kliniğinde yatarak tedavi gören 65 yaş ve üzeri toplam 370 hasta alındı. Hastaların demografik verileri ve laboratuvar sonuçları retrospektif olarak incelendi.
Bulgular: En sık hastaneye yatış nedenleri sırasıyla hiperglisemi (%29,7), anemi (%15,1), pnömoni (%10,8), akut böbrek yetmezliği (%7) ve beslenme bozukluğuydu (%6,8). Hastane içi mortalite oranı %3,5’du ve ölen hastalarda en sık yatış nedeni beslenme bozukluğuydu (%38,5). Anemi nedeniyle hastaneye yatırılan 56 hastada en sık anemi nedeni demir eksikliği anemisiydi (%62,5). En sık görülen kronik hastalıklar sırasıyla hipertansiyon (%72,4), diabetes mellitus (%62,4) ve anemiydi (%46,5). Hastaların %15,1’ine girişimsel işlem yapıldı. En sık yapılan girişimsel işlem endo-kolonoskopiydi (n=24, %6,5). Polifarmasi oranı tüm yaş gruplarında %75,7 olup 65-79 yaş grubunda %77,9, 80 yaş ve üzeri hasta grubunda %68,9 olarak saptandı (p=0.085).
Sonuç: Geriatrik yaş grubunda hiperglisemi en sık yatış nedenidir. Beslenme bozukluğu tanısı ile yatırılan hastalarda hastane içi ölüm oranı yüksektir. Anemi, geriatrik yaş grubunda sık görülmekte ve hastaneye yatış nedenleri içerisinde de önemli bir yer tutmaktadır. Bu yaş grubunda polifarmasi oranı da yüksektir.

Keywords

Geriatri, Hastanede ölüm, Komorbidite, Malnutisyon, Anemi

Evaluation of Geriatric Patients Treated in Internal Medicine Clinic

Abstract

Objective: We aimed to evaluate the demographic characteristics, reasons for hospitalization, chronic diseases and laboratory results of geriatric patients treated in the Internal Medicine Clinic.
Materials and Methods: A total of 370 patients aged 65 and over who were hospitalized in the Internal Medicine clinic between January 2015 and December 2017 were included in the study. Demographic data and laboratory results of the patients were analyzed retrospectively.
Results: The most common reasons for hospitalization were hyperglycemia (29.7%), anemia (15.1%), pneumonia (10.8%), acute renal failure (7%) and malnutrition (6.8%) respectively. The in-hospital mortality rate was 3.5% and the most common reason for hospitalization in the deceased patients was malnutrition (38.5%). In 56 patients hospitalized for anemia, the most common cause of anemia was iron deficiency anemia (62.5%). The most common chronic diseases were hypertension (72.4%), diabetes mellitus (62.4%) and anemia (46.5%), respectively. Interventional procedures were performed in 15.1% of the patients. The most common invasive procedure was endo-colonoscopy (n = 24, 6.5%). The rate of polypharmacy was 75.7% in all age groups, and it was found to be 77.9% in the 65-79 age group and 68.9% in the patient group aged 80 and over (p = 0.085).
Conclusion: Hyperglycemia is the most common reason for hospitalization in the geriatric age group. In-hospital mortality is high in patients hospitalized with a diagnosis of malnutrition. Anemia is common in the geriatric age group and has an important place among the reasons for hospitalization. In this age group, the rate of polypharmacy is also high.

Keywords

Geriatrics, Hospital mortality, Comorbidity, Malnutrition, Anemia

References

• Referans1. World Health Organization, 1984. The uses of epidemiology in the study of the elderly, Report of a WHO Scientific Group on the Epidemiology of Aging. World Health Organization Technical Report Series, Geneva, 706.
• Referans2. Kanasi E, Ayilavarapu S, Jones J. The aging population: demographics and the biology of aging. Periodontol 2000 2016;72:13-18.
• Referans3. Türkiye İstatistik Kurumu (TÜİK). Türkiye İstatistik Yıllığı 2019. www.tuik.gov.tr adresinden 05.03.2021 tarihinde ulaşılmıştır.
• Referans4. World Health Organization. Nutritional Anaemias. Report of a WHO Scientific Group. Geneva, Switzerland: World Health Organization; 1968. Technical Report Series No. 405:1-40.
• Referans5. Linjakumpu T, Hartikainen S, Klaukka T, et al. Use of medications and polypharmacy are increasing among the elderly. J Clin Epidemiol 2002;55:809-817.
• Referans6. Centers for Disease Control and Prevention and The Merck Company Foundation. The State of Aging and Health in America 2007. The Merck Company Foundation, Whitehouse Station, NJ 2007. Available at: http://www.cdc.gov/aging/pdf/saha_2007.pdf (Accessed on April 1, 2021).
• Referans7. Gülbayrak C, Açık Y, Oğuzöncül AF, Deveci SE, Ozan AT. Yenimahalle eğitim araştırma sağlık ocağına başvuran yaşlılardaki kronik hastalıkların sıklığı ve maliyeti. Eurasion J Medicine 2003;35:7-12.
• Referans8. Ünsal A, Demir G, Çoban-Özkan A, Gürol Arslan G. Huzurevindeki yaşlılarda kronik hastalık sıklığı ve ilaç kullanımları. ADÜ Tıp Fakültesi Dergisi 2011;12:5-10.
• Referans9. Çakmur H, Erem T, Koç M, et l. Kanser Tanısı Alan Geriatrik Olguların Demografik İncelemesi. Türk Geriatri Dergisi 2000;3:11-14.
• Referans10. Nalbant A, Varım C, Kaya T, Tamer A. İç Hastalıkları Kliniğinde Yatarak İzlenen 65 Yaş ve Üzeri Genel Dahiliye Hastalarında Tanısal Dağılımın Araştırılması. Sakarya Tıp Dergisi 2013;3:181-185.
• Referans11. Gaskell H, Derry S, Andrew Moore R, McQuay HJ. Prevalence of anaemia in older persons: systematic review. BMC Geriatr 2008;8:1.
• Referans12. Petrosyan I, Blaison G, Andres E, Federici I. Anaemia in the elderly: an aetiologic profile of prospective cohort of 95 hospitalized patients. Eur J Intern Med 2012;23:524-528.
• Referans13. Sezer SD, Demir B, Gülle S, Topaloğlu Ö, Akyurt MH. Incidence and Etiology of Anemia in the Hospitalized Geriatric Patients. Tepecik Eğit Hast Derg 2013;23:61-64.
• Referans14. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004;104:2263-2268.
• Referans15. Atherton WG, Harper WM, Ambrams KR. A year's trauma admissions and the effect of the weather. Injured 2005;36:40-46.
• Referans16. Diehl AK, Morris MD, Mannis SA. Use of calendar and weather data to predict walk-in attendance. South Med J 1981;74:709-712.
• Referans17. Pichler M, Hutterer GC, Stoeckigt C, et al. Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer 2013;108:901-907.
• Referans18. de Jager CP, van Wijk PT, Mathoera RB, et al. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care 2010;14:192.
• Referans19. Öztürk ZA, Yesil Y, Kuyumcu ME, Bilici M, Öztürk N, Yeşil NK, et al. Inverse relationship between neutrophil lymphocyte ratio (NLR) and bone mineral density (BMD) in elderly people. Arch Gerontol Geriatr 2013;57:81-85.
• Referans20. Cin P, Tanrıöver Ö. Geriyatrik popülasyonda yaşlanma anoreksisi. Jour Turk Fam Phy 2020;11: 29-40.
• Referans21. Vellas BLaque S, Andrea S, Pourhashemi F, Rolland Y, Baumgartner R, Garry P. Nutrition assessment in the elderly. Curr Opin Clin Nutr Metab Care 2001;4:5-8.
• Referans22. Tjia J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs Aging 2013;30:285–307.
• Referans23. Zed PJ, Abu-Laban RB, Balen RM, Loewen PS, Hohl CM, Brubacher JR, et al. Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. CMAJ 2008;178:1563–1569.
• Referans24. Wawruch M, Zikavska M, Wsolova L, Kuzelova M, Tisonova J, Gajdosik J, et al. Polypharmacy in elderly hospitalized patients in Slovakia. Pharm World Sci 2008;30:235-242.
• Referans25. Onder G, Liperoti R, Fialova D, Topinkova E, Tosato M, Danese P, et al.; SHELTER Project. Polypharmacy in nursing home in Europe: results from the SHELTER study. J Gerontol A Biol Sci Med Sci 2012;67:698-704.
• Referans26. Cankara F, Aşcı H, Sönmez Y. Üniversite hastanesinde yatan hastaların profili, hekimlerin ilaç tercihleri ve polifarmasi varlığı. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi 2015;6:20-25.