Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients

DÖĞER, Cihan; POLAT, Şefika Burçak; ERSOY, Reyhan; ÇUHACI SEYREK, FATMA NESLİHAN; ÖĞMEN, BERNA; Izdes, Seval; ÇAKIR, Bekir

Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients

FATMA NESLİHAN ÇUHACI SEYREK, (Atatürk Training and Research Hospital)

Berna ÖĞMEN, (Atatürk Training and Research Hospital)

Cihan DÖĞER, (Atatürk Training and Research Hospital, Clinic of Anesthesiology, Ankara, Turkey)

Şefika Burçak POLAT, (Atatürk Training and Research Hospital)

Seval İZDEŞ, (Atatürk Training and Research Hospital, Clinic of Anesthesiology, Ankara, Turkey)

Reyhan ERSOY, (Atatürk Training and Research Hospital)

Bekir ÇAKIR (Atatürk Training and Research Hospital)

Turkish Journal of Endocrinology and Metabolism

1 1

Yıl: 2017 Cilt: 21 Sayı: 1 Sayfa Aralığı: 1 - 8 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients

Öz:

Amaç: Yoğun bakım hastalarında prognozu ve klinik sonuçları etkileyebilen metabolik ve endokrinolojik değişiklikler olabilmektedir. Biz bu prospektif çalışmamızda, erişkin yoğun bakım ünitesine kabul edilen hastalarda yoğun bakıma kabulde ve 15 gün sonra hipofiz-adrenal-gonad ve tiroid aksında değişiklik olup olmadığını ve bu değişikliklerin prognoz ve mortaliteye katkısı olup olmadığını değerlendirmeyi amaçladık. Ayrıca bu hormonal değişiklikler ile Akut Fizyoloji Skoru II (APACHE II), SOFA skorları, hastanede yatış süresi ve mortalite arasında ilişki olup olmadığını inceledik.Gereç ve Yöntem: Çalışmaya 157 hasta dahil edildi. Hastalık ciddiyeti APACHE II ve SOFA skorları ile değerlendirildi. Hormonal değerlendirme için kan örnekleri yoğun bakıma kabulde ilk 4 saatde ve 15 gün sonra alındı. Bulgular: Hastaların 85'i survival (S), 72'i non-survival (NS) gurubunda idi. NS gurubunda, yaş ortancası, bazal APACHE II skoru, APACHE II mortalite ortancası ve SOFA skorları S gurubundan anlamlı daha yüksek idi. Bazal endokrin parametrelerine göre mortalite üzerinde belirleyici faktörler yaş, bazal SOFA skoru, hastanede yatış süresi ve yoğun bakıma kabulden 15 gün sonra yaş ve ? TSH'deki değişim idi. Tartışma: Çalışmamız ? TSH'deki değişim dışında endokrin parametrelerinin hiçbirinin mortaliteye katkısı olmadığını saptamıştır. Üçüncü basamak mikst tip yoğun bakım ünitesinde prognozun belirlenmesinde APACHE II veya SOFA skorları ile ? TSH'deki değişimin kullanılabileceğini düşünmekteyiz

Anahtar Kelime:

Konular: Endokrinoloji ve Metabolizma

Yoğun Bakım Hastalarında Hormonal Değişimin Hastalık Ciddiyeti ve Mortalite ile İlişkisi

Öz:

Purpose: Endocrine and metabolic changes, which may affect the prognosis and outcome, can occur in critically ill patients. In this prospective study, we aimed to evaluate the changes in the pituitary-adrenal-gonadal-thyroid axis in patients admitted to the adult intensive care unit on admission and 15 days later and also to evaluate whether these hormonal changes contribute to prognosis and mortality as well as to investigate the association between these hormonal changes and Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores, length of hospitalization, and mortality. Material and Method: One hundred and fifty seven patients were enrolled in this study. Severity of illness was assessed by APACHE II and SOFA scores. Blood samples were collected within the first 4 hours of intensive care unit admission and 15 days later for hormonal evaluation.Results: Eighty-five patients were in survival (S), 72 were in the non-survival (NS) group. The median age, and baseline APACHE II, median APACHE II mortality and SOFA scores in NS group were significantly higher than in S group. According the baseline endocrine parameters, the predictive factors on mortality were age, baseline SOFA score and hospitalization length and also, 15 days after the admission, age and Δ TSH were found be the predictive factors in mortality.Discussion: Our study revealed that none of the endocrine parameters contribute to mortality except Δ TSH. We assume that Δ TSH can be used together with APACHE II or SOFA scores in the prediction of prognosis in a tertiary mixed type intensive care unit

Anahtar Kelime:

Konular: Endokrinoloji ve Metabolizma

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÇUHACI SEYREK F, ÖĞMEN B, DÖĞER C, POLAT Ş, Izdes S, ERSOY R, ÇAKIR B (2017). Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. , 1 - 8.
Chicago	ÇUHACI SEYREK FATMA NESLİHAN,ÖĞMEN BERNA,DÖĞER Cihan,POLAT Şefika Burçak,Izdes Seval,ERSOY Reyhan,ÇAKIR Bekir Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. (2017): 1 - 8.
MLA	ÇUHACI SEYREK FATMA NESLİHAN,ÖĞMEN BERNA,DÖĞER Cihan,POLAT Şefika Burçak,Izdes Seval,ERSOY Reyhan,ÇAKIR Bekir Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. , 2017, ss.1 - 8.
AMA	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. . 2017; 1 - 8.
Vancouver	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. . 2017; 1 - 8.
IEEE	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B "Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients." , ss.1 - 8, 2017.
ISNAD	ÇUHACI SEYREK, FATMA NESLİHAN vd. "Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients". (2017), 1-8.

APA	ÇUHACI SEYREK F, ÖĞMEN B, DÖĞER C, POLAT Ş, Izdes S, ERSOY R, ÇAKIR B (2017). Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. Turkish Journal of Endocrinology and Metabolism, 21(1), 1 - 8.
Chicago	ÇUHACI SEYREK FATMA NESLİHAN,ÖĞMEN BERNA,DÖĞER Cihan,POLAT Şefika Burçak,Izdes Seval,ERSOY Reyhan,ÇAKIR Bekir Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. Turkish Journal of Endocrinology and Metabolism 21, no.1 (2017): 1 - 8.
MLA	ÇUHACI SEYREK FATMA NESLİHAN,ÖĞMEN BERNA,DÖĞER Cihan,POLAT Şefika Burçak,Izdes Seval,ERSOY Reyhan,ÇAKIR Bekir Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. Turkish Journal of Endocrinology and Metabolism, vol.21, no.1, 2017, ss.1 - 8.
AMA	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. Turkish Journal of Endocrinology and Metabolism. 2017; 21(1): 1 - 8.
Vancouver	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients. Turkish Journal of Endocrinology and Metabolism. 2017; 21(1): 1 - 8.
IEEE	ÇUHACI SEYREK F,ÖĞMEN B,DÖĞER C,POLAT Ş,Izdes S,ERSOY R,ÇAKIR B "Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients." Turkish Journal of Endocrinology and Metabolism, 21, ss.1 - 8, 2017.
ISNAD	ÇUHACI SEYREK, FATMA NESLİHAN vd. "Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients". Turkish Journal of Endocrinology and Metabolism 21/1 (2017), 1-8.