Yıl: 2018 Cilt: 21 Sayı: 3 Sayfa Aralığı: 323 - 332 Metin Dili: İngilizce DOI: 10.31086/tjgeri.2018344046 İndeks Tarihi: 03-07-2019

NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS

Öz:
Introduction: There is an increased number of elderly patients in intensive care units.Decreased physiological reserve and frailty makes them more vulnerable to illnesses.Materials and Method: Geriatric intensive care unit patients (n=1093), who had nohistory of malignancy and chemotherapy with hospitalised more than 3 days were examinedretrospectively. Clinical and laboratory values on admission and at the final, discharge or dead,were recorded. Non traditional mortality predictors neutrophil,to,lymphocyte count (NLR) andmean platelet volume (MPV), and timely changes of these parameters were examined.Results: Readily measurable and effective markers foreseeing outcome are vitalimportance. In this retrospective cohort, we showed that neutrophil-to-lymphocyte count(NLR) and mean platelet volume (MPV) are independent mortality predictors in geriatricpatients. In addition timely changed NLR and MPV were also independent mortality predictors[0.41 (95% CI 0.30-0.55) p<0.001 and 0.43 (95% CI 0.31-0.59) p<0.001, respectively].Conclusions: These easily measurable and cheap parameters can be good patient followup parameters in geriatrics patients who have increased mortality due to cardiovascular andsepsis related diseases.
Anahtar Kelime:

Konular: Cerrahi

GERİATRİK YOĞUN BAKIM HASTALARINDA MORTALİTE ÖNGÖRÜCÜLERİ

Öz:
Giriş: Yoğun bakımlarda izlenen geriatrik hasta sayısı giderek artmaktadır. Fizyolojik rezervlerin azalması ve kırılganlık, bu hastaları, daha savunmasız hale getirmektedir. Prognozu öngörmede, kolay ölçülebilen ve etkili göstergeler hayati önem taşımaktadır. Gereç ve Yöntem: Bu çalışmada, yoğun bakım ünitesinde 3 günden fazla yatarak izlenen, herhangi bir malignite ve kemoterapi öyküsü olmayan geriatrik hastaların (n=1093) verileri retrospektif olarak incelenmiştir. Hastaların laboratuvar ve klinik verileri, kliniğe giriş ve sonlanım olmak üzere kaydedildi. Geleneksel olmayan mortalite öngörücüleri; nötrofil-lenfosit oranı (NLO) ve ortalama trombosit hacmi (MPV) ve bu parametrelerin zamansal değişimi incelenmiştir. Retrospektif kohort çalışmamızda, geriatrik hastalarda nötrofil-lenfosit oranı (NLO) ve ortalama trombosit hacminin (MPV) bağımsız mortalite prediktörleri olduğunu saptadık. Aynı zamanda, NLO ve MPV’nin zamanla değişiminin de mortalite göstergesi olduğunu saptadık [sırasıyla 0.41 (% 95CI 0.30-0.55) p<0.001 ve 0.43 (% 95CI 0.31-0.59) p<0.001]. Sonuç: Bu kolay ölçülebilen ve ucuz elde edilebilen göstergeler, kardiyovasküler ve sepsisle ilişkili hastalıklara bağlı mortalite oranı artmış geriatri hastalarında, iyi birer hasta başı takip parametresi olabilirler.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Marik PE. Management of the critically ill geriatric patient. Crit Care Med 2006;34:S176-S82. (PMID:16917421).
  • Aksoydan E. Are developing countries ready for ageing populations? An examination on the sociodemographic, economic and health status of elderly in Turkey. Turkish Journal of Geriatrics 2009;12(2):102– 9. (in Turkish).
  • Wang X, Zhang G, Jiang X, Zhu H, Lu Z, Xu L. Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis 2014;234(1):206-13. (PMID:24681815).
  • Yılmaz G, Sevinc C, Ustundag S, et al. The relationship between mean platelet volume and neutrophil/ lymphocyte ratio with inflammation and proteinuria in chronic kidney disease. Saudi J Kidney Dis Transpl 2017;28(1):90-4. (PMID:28098108).
  • Cataudella E, Giraffa CM, Di Marca S, et al. neutrophilto-lymphocyte ratio: an emerging marker predicting prognosis in elderly adults with community-acquired pneumonia. J Am Geriatr Soc 2017;65(8):1796-801. (PMID:28407209).
  • Hirakata H, Nitta K, Inaba M, et al. Japanese Society for Dialysis Therapy. Japanese Society for Dialysis Therapy guidelines for management of cardiovascular diseases in patients on chronic hemodialysis. Ther Apher Dial 2012;16(5):387-435. (PMID:23046367).
  • Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg 2003;237(3):319–34. (PMID:12616115).
  • Mohamed AKS, Mehta AA, James P. Predictors of mortality of severe sepsis among adult patients in the medical Intensive Care Unit. Lung India 2017;34(4):330-5. (PMID:28671163).
  • Susantitaphong P, Cruz DN, Cerda J, et al. World incidence of AKI: a meta-analysis. Clinical journal of the American Society of Nephrology: CJASN 2013;8:1482-93. (PMID:23744003).
  • Fang Y, Ding X, Zhong Y, et al. Acute kidney injury in a Chinese hospitalized population. Blood purification 2010;30:120–6. (PMID:20714143).
  • Sodhi K, Singla MK, Shrivastava A, Bansal N. Do intensive care unit treatment modalities predict mortality in geriatric patients: An observational study from an Indian Intensive Care Unit. Indian J Crit Care Med 2014 Dec;18(12):789-95. (PMID:25538413).
  • Farrell SG, Mitnitski AB, Rockwood K, Rutenberg AD. Network model of human aging: frailty limits and information measures. Phys Rev E 2016;94(5- 1):052409. (PMID:27967091).
  • Rutenberg AD, Mitnitski AB, Farrell S, Rockwood K. Unifying aging and frailty through complex dynamical networks. Exp Gerontol 2017. pii: S0531- 5565(17)30482-5. (PMID:28847723).
  • Rayner BL, Goodman H, Opie LH. The chest radiograph. A useful investigation in the evaluation of hypertensive patients. Am J Hypertens 2004;17:507-10. (PMID:15177523).
  • Giamouzis G, Sui X, Love TE, et al. A propensitymatched study of the association of cardiothoracic ratio with morbidity and mortality in chronic heart failure. Am J Cardiol 2008;101:343-7. (PMID:18237597).
  • Sanders-van Wijk S, Maeder MT, Nietlispach F, et al.Long-term results of intensified, N-terminal-proB-type natriuretic peptide-guided versus symptomguided treatment in elderly patients with heart failure: five-year follow-up from TIME-CHF. Circ Heart Fail 2014 Jan;7(1):131-9. (PMID:24352403).
  • Sanders-van Wijk S, van Asselt AD, Rickli H, et al. Cost-effectiveness of N-terminal pro-B-type natriuretic-guided therapy in elderly heart failure patients: results from TIME-CHF (Trial of Intensified versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure). JACC Heart Fail 2013;1(1):64-71. (PMID:24621800).
  • Thakar CV, Christianson A, Freyberg R, Almenoff P, Render ML. Incidence and outcomes of acute kidney injury in intensive care units: a veterans administration study. Crit Care Med 2009;37:2552-8. (PMID:19602973).
  • Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis 2009;53:961-73. (PMID:19346042).
  • Sun X, Luo L, Zhao X, Ye P, Du R. The neutrophil-tolymphocyte ratio on admission is a good predictor for all-cause mortality in hypertensive patients over 80 years of age. BMC Cardiovasc Disord 2017;17(1):167. (PMID:28646855).
  • Suh B, Shin DW, Kwon HM, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One 2017;12(8):e0183706. (PMID:28829826).
  • Öztürk ZA, Kuyumcu ME, Yeşil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013;36:593-9. (PMID:23511196).
  • Choi DH, Kang SH, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med 2016;31(6):1009-1017. (PMID:27776204).
  • Kim CH, Kim SJ, Lee MJ, et al. An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PLoS One 2015;10(3):e0119437. (PMID:25742300).
  • Taskesen T, Sekhon H, Wroblewski I, et al. Usefulness of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients With Non-STElevation Acute Coronary Syndromes. Am J Cardiol 2017;119(2):192-6. (PMID:27814786).
APA BOZKURT D, KILAVUZ A, CAFEROV N, KÖSE T, Akçiçek S (2018). NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. , 323 - 332. 10.31086/tjgeri.2018344046
Chicago BOZKURT Devrim,KILAVUZ ASLI,CAFEROV Namig,KÖSE Timur,Akçiçek Selahattin Fehmi NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. (2018): 323 - 332. 10.31086/tjgeri.2018344046
MLA BOZKURT Devrim,KILAVUZ ASLI,CAFEROV Namig,KÖSE Timur,Akçiçek Selahattin Fehmi NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. , 2018, ss.323 - 332. 10.31086/tjgeri.2018344046
AMA BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. . 2018; 323 - 332. 10.31086/tjgeri.2018344046
Vancouver BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. . 2018; 323 - 332. 10.31086/tjgeri.2018344046
IEEE BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S "NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS." , ss.323 - 332, 2018. 10.31086/tjgeri.2018344046
ISNAD BOZKURT, Devrim vd. "NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS". (2018), 323-332. https://doi.org/10.31086/tjgeri.2018344046
APA BOZKURT D, KILAVUZ A, CAFEROV N, KÖSE T, Akçiçek S (2018). NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. Türk Geriatri Dergisi, 21(3), 323 - 332. 10.31086/tjgeri.2018344046
Chicago BOZKURT Devrim,KILAVUZ ASLI,CAFEROV Namig,KÖSE Timur,Akçiçek Selahattin Fehmi NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. Türk Geriatri Dergisi 21, no.3 (2018): 323 - 332. 10.31086/tjgeri.2018344046
MLA BOZKURT Devrim,KILAVUZ ASLI,CAFEROV Namig,KÖSE Timur,Akçiçek Selahattin Fehmi NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. Türk Geriatri Dergisi, vol.21, no.3, 2018, ss.323 - 332. 10.31086/tjgeri.2018344046
AMA BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. Türk Geriatri Dergisi. 2018; 21(3): 323 - 332. 10.31086/tjgeri.2018344046
Vancouver BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS. Türk Geriatri Dergisi. 2018; 21(3): 323 - 332. 10.31086/tjgeri.2018344046
IEEE BOZKURT D,KILAVUZ A,CAFEROV N,KÖSE T,Akçiçek S "NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS." Türk Geriatri Dergisi, 21, ss.323 - 332, 2018. 10.31086/tjgeri.2018344046
ISNAD BOZKURT, Devrim vd. "NON-TRADITIONAL MORTALITY PREDICTORS FOR GERIATRIC INTENSIVE CARE UNIT PATIENTS". Türk Geriatri Dergisi 21/3 (2018), 323-332. https://doi.org/10.31086/tjgeri.2018344046