Acil Serviste Sedyeden Düşen Geriatrik Hastaların Mortalite Analizi: Retrospektif Klinik Çalışma

Yıl 2024, Cilt: 7 Sayı: 1, 8 - 14, 31.03.2024

Habibe Selmin Özensoy , Fatih Ahmet Kahraman , Selahattin Gürü , Sedat Özbay , Orhan Özsoy , Hakan Oğuztürk

https://doi.org/10.54996/anatolianjem.1421178

Öz

Amaç: Bu çalışmada, acil serviste seden düşme sonucu başvuran geriatrik hastaların yaşadığı yaralanmalar, mortalite, acil serviste geçirilen süre ve hastanede kalış sürelerini incelemeyi ve
bu sorunlara neden olan hastaların özelliklerini belirlemeyi amaçladık.

Gereç ve Yöntemler: Çalışma retrospektif olarak yürütülmüş olup, acil serviste seden düşen hastaların verileri 1 Ocak 2020 ile 31 Aralık 2022 tarihleri arasında incelenmiştir. Çalışmada hasta kayıtları ve elektronik sistem verileri kullanılmıştır. Hastaların demografik bilgileri, başvuru nedenleri, düşme detayları, Itachi düşme skoru, hastanede kalış süreleri ve mortalite kaydedilmiştir.

Bulgular: Acil serviste seden toplam 87 hasta incelenmiştir. Hastaların yaş ortalaması 69 yıl idi (18-95 yaş aralığı). Bu hastaların 56'sı 65 yaş ve üzerindeydi. Hastalarımızdan 2'sinde (%2,3) düşme nedeniyle ölüm gerçekleşmiştir. 65 yaş ve üzeri hastalarda median Itachi skoru 8 (1-26) olarak belirlenmiştir. Düşmelere bağlı mortalite, kranial travma ile önemli derecede ilişkilidir (p<0.001).

Sonuç: Acil serviste seden geriatrik hastaların mortalitesi daha yüksektir. Bu durumu önlemek için tedbirler alınmalıdır.

Anahtar Kelimeler

Geriatrik hastalar, acil servis, sedye, düşme

Mortality Analysis of Geriatric Patients Who Fell Off The Stretcher in The Emergency Department: A Retrospective Clinical Study

Öz

Aim: In this study, we wanted to examine the injuries, mortality, length of stay in the emergency department, and length of hospital stay of geriatric patients who applied to the emergency
department after falling off the stretcher in the emergency department, and to determine which characteristics of the patients caused these problems.

Material and Methods: The study was conducted retrospectively and the data of patients who fell off the stretcher in the emergency department between January 1, 2020 and December 31, 2022 were examined. Patient records and electronic system data were used in the study. The patients' demographic information, chief complaints, fall details, Itachi fall score, length of hospital stay, and mortality were documented.

Results: The results of a total of 87 patients who fell off the stretcher in the Emergency Department were analyzed. The median age of the patients was 69 years (range 18-95). 56 of these patients were 65 years of age or older. Death occurred due to falls in 2 of our patients (2.3%). The median Itachi score in patients aged 65 and over was determined as 8 (1-26). Mortality due to falls was significantly related to cranial trauma (p<0.001).

Conclusion: Geriatric patients falling off the stretcher in the emergency department is more mortal. Measures must be taken to prevent it.

Anahtar Kelimeler

Geriatric patients, emergency department, stretcher, falling

Etik Beyan

The study was approved by the Ethics Committee of Ankara City Hospital with E2-23-3810 on 12,04,2021.

Kaynakça

• Torrance AD, Powell SL, Griffiths EA. Emergency surgery in the elderly: challenges and solutions. Open Access Emerg Med. 2015;7:55-68.
• "İstatistiklerle Yaşlılar, 2022 https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2022 49667#:~:text=Ya%C5%9Fl%C4%B1%20n%C3%BCfusun%202022%20y %C4%B1l%C4%B1nda%20%44,%25%2C6%20olaca%C4%9F%C4%B1%2 0%C3%B6ng%C3%B6r%C3%BCld%C3%BC”
• Ahmedov Y, Ahmedov A. Acil Serviste Yatan Hastaların Düşme Risklerinin Belirlenmesi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2021;37(3):207-16.
• Said CM, Churilov L, Shaw K. Validation and inter-rater reliability of a three item falls risk screening tool. BMC geriatrics. 2017;17:1-6.
• Hemsley B, Steel J, Worrall L, Hill S, Bryant L, Johnston L, et al. A systematic review of falls in hospital for patients with communication disability: highlighting an invisible population. Journal of safety research. 2019;68:89-105.
• Soyuer E, İsmailoğulları S. Aging and Balance. 2009; 15(1): 1-5
• Yaşar G, Gülengün T. Hasta düşmelerinde risk faktörlerinin belirlenmesi. Hemşirelik Bilimi Dergisi. 2018;1(1):15-20.
• International patient safety goals 2023 [Available from: https://www.jointcommissioninternational.org/standards/international-patient-safety-goals/.
• Kang YO, Song R. Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis. Korean Journal of Adult Nursing. 2015;27(1).
• Turner JP, Tervonen HE, Shakib S, Singhal N, Prowse R, Bell JS. Factors associated with use of falls risk–increasing drugs among patients of a geriatric oncology outpatient clinic in Australia: a cross‐sectional study. Journal of evaluation in clinical practice. 2017;23(2):361-8.
• Ayhan Y, İnterpeler ŞS. Yakın iş birliğine dayalı ileri araştırma ve klinik uygulama modeli: Kanıta dayalı düşme önleme stratejilerinin kullanımı. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2015;8(3):195-202.
• Tanıl V, Çetinkaya Y, Sayer V, Avşar D, İskit Y. Düşme riskinin değerlendirilmesi. Sağlık Akademisyenleri Dergisi. 2014;1(1):21-6.
• Clemson L, Mackenzie L, Roberts C, Poulos R, Tan A, Lovarini M, et al. Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectiveness-implementation design. Implementation science. 2017;12:1-12.
• Oden TN, Van Giersbergen MY. Düşme ve düşmelere bağlı yaralanmaların azaltılması için kanıt temelli uygulama önerileri. Sağlıkta Performans ve Kalite Dergisi. 2021;18(1):17-40.
• Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Frontiers in public health. 2022;10:902599.
• Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010–2040. British journal of cancer. 2012;107(7):1195-202.
• Stone CA, Lawlor PG, Savva GM, Bennett K, Kenny RA. Prospective study of falls and risk factors for falls in adults with advanced cancer. J Clin Oncol. 2012;30(17):2128-33.
• Kafantogia K, Katsafourou P, Tassiou A, Vassou N. Falls among hospitalized patients. Journal of frailty, sarcopenia and falls. 2017;2(3):53.
• Engstrom CJ, Adelaine S, Liao F, Jacobsohn GC, Patterson BW. Operationalizing a real-time scoring model to predict fall risk among older adults in the emergency department. Frontiers in digital health. 2022;4:958663.
• Kuş B, Büyükyılmaz F, Ardıç A. Comparison of three fall risk assessment tools in older hospitalized patients in Turkey: analysis of sensitivity and specificity. Aging clinical and experimental research. 2023;35(5):1033-41.
• Zou M, Lu R, Jiang Y, Liu P, Tian B, Liang Y, et al. Association between toileting and falls in older adults admitted to the emergency department and hospitalised: a cross-sectional study. BMJ open. 2023;13(6):e065544.