GKD Anest Yoð Bak Dern Derg. 2022; 28(3): 269-275 | DOI: 10.14744/GKDAD.2022.67984

Üçüncü Basamak Yoðun Bakým Ünitelerinde Uzamýþ Yatýþlarýn Analizi

Hayriye Cankar Dal¹, Hasan Oktay Emir¹, Alper Bayar¹, Abdulaziz Aysel², Hülya Þirin³, Çilem Bayýndýr Dicle¹, Cihangir Doðu¹, Sema Turan^1
1Saðlýk Bilimleri Üniversitesi, Ankara Þehir Hastanesi, Yoðun Bakým Kliniði, Ankara, Türkiye
²Saðlýk Bilimleri Üniversitesi, Ankara Þehir Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Ankara, Türkiye
³Saðlýk Bilimleri Üniversitesi, Gülhane Týp Fakültesi, Halk Saðlýðý Kliniði, Ankara, Türkiye

Amaç: Çalýþmada, saðlýk harcamalarýnda önemli yer tutan yoðun bakýmlarda yatýþ süresi uzamýþ hastalarýn özelliklerinin tanýmlanmasý, uygulanan tedavi modalitelerinin tespiti ve hasta sonlanýmlarýnýn belirlenmesi amaçlandý.
Yöntem: Tek merkezli, retrospektif ve gözlemsel olarak dizayn edilen çalýþmaya, Ankara'da üçüncü basamak bir yoðun bakým ünitesinde 01 Ocak 2021 ile 01 Ocak 2022 tarihleri arasýnda 30 gün ve üzeri yatýþý olan hastalar dahil edildi. Hastalarýn demografik ve klinik özellikleri, yatýþ tanýlarý, mekanik ventilasyon ve diðer uygulanan tedavi modaliteleri, yoðun bakýmda kalýþ süreleri, taburculuk þekilleri ve mortalite oranlarý kaydedildi.
Bulgular: Çalýþma tarihleri arasýnda 1961 hasta üçüncü basamak yoðun bakýmda hastaneye yatýrýldý. Otuz gün ve üzeri yoðun bakým yatýþý olan 168 hasta deðerlendirmeye alýndý. Yaþ ortalamasý 66,93±19,85 yýl idi. Medyan yoðun bakýmda yatýþ süresi 45,00 (30-328) gün, en sýk yoðun bakýma kabul nedeni solunum yetmezliði (%38,7) olup mortalite oraný %51,20 olarak saptandý. “Acute Physiology and Chronic Health Evaluation-II” skoru, entübasyon uygulanma oranlarý, inotrop veya vazopresör destek kullanýmý, kan ürünü replasmaný, renal replasman tedavi uygulanma oranlarý sað kalan olmayan grupta anlamlý olarak daha yüksek bulundu.
Sonuç: Çalýþmada 30 gün ve üzeri yatýþý olan hastalarýn yarýsýnda mortalite geliþtiði tespit edildi. Çalýþmanýn, uzamýþ yoðun bakým hastalarýnýn özelliklerinin tanýmlanmasý, yatýþ sürecince kullanýlan kaynaklarýn tespiti ve hasta sonlanýmlarýnýn belirlenmesi konusunda ileride yapýlacak çalýþmalara ýþýk tutacaðý, yoðun bakým organizasyonu ve kaynaklarýn etkin kullanýmý açýsýndan yol gösterici olabileceði kanýsýndayýz.

Anahtar Kelimeler: Mortalite, uzamýþ yoðun bakým, yatýþ süresi, yoðun bakým

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Analysis of Prolonged Hospitalizations in Tertiary Intensive Care Units

Hayriye Cankar Dal¹, Hasan Oktay Emir¹, Alper Bayar¹, Abdulaziz Aysel², Hülya Þirin³, Çilem Bayýndýr Dicle¹, Cihangir Doðu¹, Sema Turan^1
1Department of Intensive Care Unit, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
²Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
³Department of Public Health, University of Health Sciences, Gulhane Faculty of Medicine, Ankara, Türkiye

Objectives: It is aimed to define the characteristics of patients with pro-longed hospitalization in intensive care units (ICU), which has an important place in health expenditures, to determine the treatment modalities applied, and to determine patient outcomes.
Methods: The single-center, retrospective, and observational study included patients hospitalized for 30 days or more between January 2021 and January 2022 in a tertiary ICU. Demographic and clinical characteristics of the patients, hospitalization diagnoses, mechanical ventilation and other treatment modalities, ICU stay, discharge patterns, and mortality rates were recorded.
Results: Between the study dates, 1961 patients were hospitalized in the tertiary ICU. One hundred and sixty-eight patients with ICU hospitalization for 30 days or more were included in the evaluation. The mean age is 66.93±19.85 years. The median ICU stay was 45.00 (30–328) days, the most common ICU admission etiology was a respiratory failure (38.7%), and the mortality rate was 51.20%. The non-survivor group was shown to have considerably higher rates of APACHE-II score, intubation, use of inotropic or vasopressor support, blood product replacement, and renal replacement therapy.
Conclusion: In our study, in which patients with ICU hospitalization for 30 days or more were evaluated, mortality was found in half of the patients. We believe that our research will shed light on future studies on defining the characteristics of prolonged ICU patients, identifying the resources used during the hospitalization process, and determining patient outcomes and may be a guide in terms of the organization of ICU and effective use of resources.

Keywords: Intensive care, length of stay, mortality, prolonged intensive care

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