Yoðun bakým hastalarýnda hemogram parametrelerinin mortaliteyle iliþkisi

GÝRÝÞ ve AMAÇ: Yoðun bakýmda mortaliteyi tahmin etmede son zamanlarda çeþitli hemogram parametreleri kullanýlmaktadýr. Bu parametrelerin hýzlý bir þekilde kritik hastalarda karar verme, uygun tedaviye baþlama gibi avantajlarý bulunmaktadýr. Bu çalýþmada; 1 Ocak 2014 ile 30 Nisan 2018 yýllarý arasýnda Cumhuriyet Üniversitesi Týp Fakültesi Araþtýrma Uygulama Hastanesi Merkezi Yoðun Bakým Ünitesinde yatan hastalarýn dosyalarý ve hastane otomasyon programý yardýmýyla retrospektif olarak inceleyip ölen hastalar ile sað kalanlar arasýnda hemogram parametrelerinin mortaliteyi tahmin etmede iliþkisini ortaya koymayý amaçladýk.
YÖNTEM ve GEREÇLER: Cumhuriyet Üniversitesi Giriþimsel olmayan Klinik Uygulamalar Etik Kurulu ve hastalarýn onayý alýndýktan sonra çalýþmaya dahil etme kriterlerimize uyan 254 hasta çalýþmaya alýndý. Tüm hastalarýn Demografik verileri ilk yatýþtaki SOFA (Sequential Organ Failure Assessment), APACHE Ⅱ (Acute Physiology and Chronic Health Evaluation) skorlarý, CRP (C-Reaktif Protein), MPV (Ortalama Trombosit hacmi), RDW (Eritrosit daðýlým geniþliði), NLO (nötrofil lenfosit oraný), PLO (Trombosit lenfosit oraný) deðerleri kaydedildi.
BULGULAR: Çalýþmaya alýnan gruplarýn hemogram deðerleri, SOFA, CRP, APACHE Ⅱ skorlarý karþýlaþtýrýldýðýnda ölen ve sað kalan gruplar arasýnda farklýlýk anlamlý bulundu. Kesim noktasý için AUROC analizi sonucu MPV için %90.3 duyarlýlýk %95.8 özgüllük ile 9.75 femtolitre; NLO için %82.8 duyarlýlýk %88.3 özgüllük ile 13.55; PLO için %97 duyarlýlýk %98.3 özgüllük ile 301.5; RDW için %92.5 duyarlýlýk %96.7 özgüllük ile 15.15; SOFA için %90.3 duyarlýlýk %30 özgüllük ile 7.5 deðeri bulundu.
TARTIÞMA ve SONUÇ: Bu çalýþmada; hemogram parametrelerinin mortaliteyi ayýrt edicilik gücünün SOFA, CRP, APACHE Ⅱ’den daha yüksek olduðunu gözlemledik.

The relation of hemogram parameters with mortality in intensive care patients.

INTRODUCTION: Various hemogram parameters have recently been used to predict mortality in intensive care unit. These parameters have advantages such as making quick decision in critical illnesses and starting appropriate treatment. In this study; We aimed to investigate the relationship predicting the mortality of the hemogram parameters between death and survivor patients whose hospitalized between January 1, 2014 and April 30, 2018 in Cumhuriyet University Medical Faculty Research Hospital Center Intensive Care Unit with the files of patients and the hospital automation program.
METHODS: After being approved by the Ethics Committee of the Non-Interventional Clinical Practices of Cumhuriyet University; 254 patients taken to work. Demographic data of all patients were recorded admission SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation) scores, CRP (C-Reactive Protein), MPV (Mean platelet volume), RDW (Red cell distrubition width), NLR (Neutrophil lymphocyte ratio), PLR (Platelet lymphocyte ratio).
RESULTS: When the values of hemogram, SOFA, CRP, APACHE II scores of the study groups were compared, there was a significant difference between the death and survivor groups. The AUROC analysis result the cut-off point for MPV was 90.3% sensitivity and 95.8% specificity 9.75 femtolitre; for NLR was 82.8% sensitivity and 88.3% specificity was 13.55; for PLR was 97% sensitivity and 98.3% specificity 301.5; for RDW was 92.5% sensitivity and 96.7% specificity 15.15; for SOFA was Sensitivity of 90.3% and 30% specificity 7.5.
DISCUSSION AND CONCLUSION: In this study; we conclude that the mortality of hemogram parameters is higher than the discriminatory power of SOFA, CRP, APACHE II.