Year 2020, Volume 5 , Issue 1, Pages 12 - 17 2020-03-19

Sepsisli geriatrik hastaların mortalitesi ile yoğun bakım ünitesine kabulündeki C-Reaktif Protein, Prokalsitonin ve Nötrofil/Lenfosit oranının ilişkisi
Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit

İsmail DEMİR [1] , Muammer YÜCEL [2]


Giriş: Sepsis, vücudun enfeksiyona karşı verdiği düzensiz yanıt nedeniyle oluşan, yaşamı tehdit eden organ fonksiyon bozukluğudur. Yaşlı hastalarda yoğun bakım ünitelerindeki (YBÜ) ölümlerin en sık sebebi sepsistir. Çalışmada Dahiliye YBÜ’de tedavi gören, sepsis tanılı 65 yaş ve üzeri hastalarda yatış esnasında CRP, prokalsitonin ve nötrofil/lenfosit oranının mortalite ile ilişkisi araştırılmıştır.
Yöntem: Kesitsel nitelikteki araştırmada SBÜ Bozyaka Eğitim Araştırma Hastanesi Dahiliye YBÜ’de Haziran 2018 ve Mayıs 2019 tarihleri arasında (12 ay) yatan sepsis tanılı 207 olgunun kayıtları geriye dönük olarak incelendi. Hastaların demografik verileri ile birlikte APACHE II skoru, SOFA skoru, sistemik hastalık varlığı, ilk alınan kan örneklerinden CRP, prokalsitonin, tam kan sayımı, yoğun bakım kalış süresi ve mortalite durumu kaydedildi.
Bulgular: Yoğun Bakım Ünitesinde 12 aylık süreçte izlenen sepsis tanılı 207 geriatrik hastanın yaş ortalaması 77,6±8,4 yıl olup %51.7’si (n=107) kadındı. Olguların 73’ü (%35,3) sepsis nedeniyle yaşamını yitirirken, 134’ü (%64,7) sağ kalan grubu oluşturdu. Sağkalan ve ölen hasta grupları arasında yatış süresi açısından fark saptanmadı (p=0,880). APACHE-II ve SOFA skorları, sağ kalan ve ölen hastalar arasında istatistiksel olarak farklı bulundu (p<0,001). Sağ kalan hasta grubunda prokalsitonin ortalaması 3,54±4,77 µg/L iken ölen hasta grubunda 20,83±12,18 µg/L olarak saptandı (p<0,001). Sağ kalan hasta grubunda CRP ortalaması 97,7±77,4 mg/L iken ölen hasta grubunda 136,9±100,8 mg/L idi (p=0,002). Sağ kalan ve ölen hasta gruplarının tam kan sayımı parametrelerinden lökosit, nötrofil, lenfosit sonuçlarında anlamlı fark yoktu. Nötrofil/lenfositoranı sağ kalan grupta 7,49±6,83 iken, ölen hasta grubunda 12,73±15,09 idi (p=0,006).
Sonuç: YBÜ’nde yatan hastaların mortalite oranları diğer servislerde yatan hastalara gore daha yüksektir. Yatış esnasındaki tam kan sayımı parametrelerinin yanında nötrofil/lenfositoranı, CRP ve prokalsitonin sonuçlarının sistematik bulgularla değerlendirilmesi hastaların yoğun bakım akıbetlerinin öngörülmesinde değerli olabilir. 

Introduction: Sepsis is defined as life-threatening organ dysfunction caused by the body's irregular response to infection. Sepsis is the most common cause of death in intensive care units in elderly patients. The effect of CRP, procalcitonin levels and neutrophil/lymphocyte ratio at the time of admission on mortality of internal diseases patients in ICU over 65 years of age are investigated in this study.
Methods: The medical records of 207 patients with sepsis hospitalized between June 2018 and May 2019 in the Internal Medicine ICU of Bozyaka Training and Research Hospital were evaluated retrospectively in this cross-sectional study. Demographic data, APACHE II score, SOFA score, presence of systemic disease, CRP, procalcitonin, complete blood count, ICU stay and mortality status were recorded.
Results: The mean age of the geriatric patients with 207 sepsis hospitalized in the ICU over a 12-month period was 77.6±8.4 years. The study group consisted of 100 (48.3%) males and 107 (51.7%) females. In the study, 73(35.3%) of the patients died due to sepsis, 134(64.7%) were the surviving group. There was no difference between surviving and deceased patient groups in terms of length of stay (p=0.880). APACHE-II and SOFA scores were found to be statistically different between surviving and deceased patients (p<0.001). The mean procalcitonin level was 3.54±4.77µg/L among the surviving group and 20.83±12.18µg/L among the deceased patient group (p<0.001). The mean CRP was 97.7±77.4mg/L by the surviving group and 136.9±100.8 mg/L by the deceased patient group (p=0.002). The neutrophil/lymphocyte ratio was 7.49±6.83 in the surviving group and 12.73±15.09 in the deceased patient group (p=0.006).
Conclusion: Mortality rates of inpatients in ICU were higher than inpatients in other wards. Systematic evaluation of neutrophil/lymphocyte ratio, CRP and procalcitonin results, as well as complete blood count parameters during hospitalization, may be valuable in predicting intensive care outcomes of patients.

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Primary Language en
Subjects General and Internal Medicine
Published Date Apr 2020
Journal Section Original Research
Authors

Orcid: 0000-0001-7787-1443
Author: İsmail DEMİR (Primary Author)
Institution: Department of Internal Medicine, Izmir Bozyaka Training & Research Hospital, University of Health Sciences, Izmir
Country: Turkey


Orcid: 0000-0002-1646-3953
Author: Muammer YÜCEL (Primary Author)
Institution: Department of Biochemistry, Izmir Ataturk Training & Research Hospital, Izmir Katip Celebi University, Izmir
Country: Turkey


Dates

Application Date : November 25, 2019
Acceptance Date : March 18, 2020
Publication Date : March 19, 2020

Bibtex @research article { fppc650570, journal = {Family Practice and Palliative Care}, issn = {2458-8865}, eissn = {2459-1505}, address = {}, publisher = {SERNEV}, year = {2020}, volume = {5}, pages = {12 - 17}, doi = {10.22391/fppc.650570}, title = {Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit}, key = {cite}, author = {DEMİR, İsmail and YÜCEL, Muammer} }
APA DEMİR, İ , YÜCEL, M . (2020). Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit. Family Practice and Palliative Care , 5 (1) , 12-17 . DOI: 10.22391/fppc.650570
MLA DEMİR, İ , YÜCEL, M . "Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit". Family Practice and Palliative Care 5 (2020 ): 12-17 <http://www.fppc.com.tr/en/issue/52039/650570>
Chicago DEMİR, İ , YÜCEL, M . "Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit". Family Practice and Palliative Care 5 (2020 ): 12-17
RIS TY - JOUR T1 - Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit AU - İsmail DEMİR , Muammer YÜCEL Y1 - 2020 PY - 2020 N1 - doi: 10.22391/fppc.650570 DO - 10.22391/fppc.650570 T2 - Family Practice and Palliative Care JF - Journal JO - JOR SP - 12 EP - 17 VL - 5 IS - 1 SN - 2458-8865-2459-1505 M3 - doi: 10.22391/fppc.650570 UR - https://doi.org/10.22391/fppc.650570 Y2 - 2020 ER -
EndNote %0 Family Practice and Palliative Care Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit %A İsmail DEMİR , Muammer YÜCEL %T Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit %D 2020 %J Family Practice and Palliative Care %P 2458-8865-2459-1505 %V 5 %N 1 %R doi: 10.22391/fppc.650570 %U 10.22391/fppc.650570
ISNAD DEMİR, İsmail , YÜCEL, Muammer . "Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit". Family Practice and Palliative Care 5 / 1 (March 2020): 12-17 . https://doi.org/10.22391/fppc.650570
AMA DEMİR İ , YÜCEL M . Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit. Fam Pract Palliat Care. 2020; 5(1): 12-17.
Vancouver DEMİR İ , YÜCEL M . Investigation of relation between mortality of geriatric patients with sepsis and C-Reactive Protein, Procalcitonin and Neutrophil/Lymphocyte ratio in admission to intensive care unit. Family Practice and Palliative Care. 2020; 5(1): 17-12.