Publication: Acil cerrahi yoğun bakım ünitesine transfer edilen travma hastalarında nozokomiyal pnömoni gelişimine ilişkin risk fakatörlerinin incelenmesi
Abstract
1. ÖZET Bu çalışma, acil cerrahi yoğun bakım ünitesine transfer edilen travma hastalarında nozokomiyal pnömoni gelişimine ilişkin risk faktörlerini belirlemek amacıyla tanımlayıcı ve karşılaştırmalı olarak yapıldı. Araştırmanın evrenini, İstanbul Üniversitesi İstanbul Tıp Fakültesi Travma ve Acil Cerrahi Servisi, Acil Cerrahi Yoğun Bakım Ünitesine transfer edilen 90 hasta oluşturdu. Araştırmanın evreni örneklemi teşkil etmektedir. Araştırmaya evrendeki sayıya ulaşılana kadar devam edilmiştir. Örnekleme, 18 yaş ve üzerinde olan, hastaneye başvurusunda herhangi bir pnömoni bulgusu olmayan, hastaneye başvurusundan 48 saat geçen, acil cerrahi yoğun bakım ünitesinde travma nedeniyle tedavi gören 90 hasta alındı. Araştırmada veriler veri toplama formu ile toplandı. Bulguların değerlendirilmesinde SPSS (Statistical Package for Social Sciences) for Windows 10.0 kullanıldı. Çalışma verileri değerlendirilirken tanımlayıcı istatistiksel metodların (Ortalama, Standart sapma) yanısıra niceliksel verilerin karşılaştırılmasında normal dağılım gösteren parametrelerin gruplar arası karşılaştırmalarında student t testi kullanıldı. Niteliksel verilerin karşılaştırılmasında ise Ki-Kare testi ve Fisher’s Exact Ki-Kare testi; ODDS risk analizi kullanıldı. Sonuçlar % 95’lik güven aralığında, anlamlılık p<0.05 düzeyinde değerlendirildi. Acil cerrahi yoğun bakım ünitesine transfer edilen travma hastalarında nozokomiyal pnömoni görülme oranı %33.3 olarak belirlendi. Araştırmada elde edilen sonuçlara göre, künt travma, glaskow koma skalasının düşük olması (GKS<9), yaralanma şiddet skorunun yüksek olması (ISS>30), yoğun bakım ünitesinde yatış süresinin, mekanik ventilasyon süresinin, endotrakeal entübasyon, antibiyotik kullanım süresinin uzun olması, trakeostomi, nazogastrik sonda, kafa içi basınç monitörizasyonun uygulanması, beyin cerrahisi, sedatif kullanımı, enteral beslenme acil cerrahi yoğun bakım ünitesinde yatan travma hastalarında anlamlı düzeyde risk oluşturduğu belirlendi (p<0.05). Travma, nozokomiyal pnömoni, yoğun bakım. 2.
STUDY OF RISK FACTORS OF THE NOSOCOMIAL PNEUMONIA INFECTIONS IN TRAUMA PATIENTS WHO ARE TRANSFERRED TO THE INTENSİVE CARE UNIT OF THE EMERGENCY SURGERY DEPARTMENT The aim of this study is to determine the risk factors for nosocomial infections in the trauma patients, who are transferred to the Emergency Surgery Intensive Care Unit. The investigation is based on the patiens who are transferred to the Trauma and Emergency Surgery Clinic of Istanbul Faculty of Medicine in the University of Istanbul. 90 patients, who are older then 18 years, did not have symptoms of pneumonia at the admission, who are treated in the Intensive Care Unit of the Emergency Surgery Department for at least 48 hours, were selected for this study. Data for the study is collected with information sheets. Statistical Package for Social Sciences for Windows 10.0 (SPSS) programm has been used for the evaluation of the data. Furthermore, other statistical methods like median, standart deviation and Student Test were used. Qualitative data were analised by chi-square test, and Fisher's Exact chi-square test. ODDS risk analising system is used. Results were evaluated in the intervall of 95% and the significancy at (p<0.05). Nosocomial pneumonia is detected in 33.3% of the patients, who were transferred to the Intensive Care Unit of the Emergency Surgery Department. According to the results achieved in this study, conditions such as, blunt trauma, low Glaskow Coma Index (GCI<9), high trauma severety score ( ISS>30), prolonged stay in Intensive Care Unit, prolonged ventilation, prolonged endotracheal entubation, prolonged antibiotic therapy, tracheostomy, nasogastric intubation, monitorisation of the intracerebral pressure, brain surgery, use of sedatives, enteral feeding are significant risc factors (p<0.05). Trauma, Nosocomial pneumonia, Intensive Care Unit,
STUDY OF RISK FACTORS OF THE NOSOCOMIAL PNEUMONIA INFECTIONS IN TRAUMA PATIENTS WHO ARE TRANSFERRED TO THE INTENSİVE CARE UNIT OF THE EMERGENCY SURGERY DEPARTMENT The aim of this study is to determine the risk factors for nosocomial infections in the trauma patients, who are transferred to the Emergency Surgery Intensive Care Unit. The investigation is based on the patiens who are transferred to the Trauma and Emergency Surgery Clinic of Istanbul Faculty of Medicine in the University of Istanbul. 90 patients, who are older then 18 years, did not have symptoms of pneumonia at the admission, who are treated in the Intensive Care Unit of the Emergency Surgery Department for at least 48 hours, were selected for this study. Data for the study is collected with information sheets. Statistical Package for Social Sciences for Windows 10.0 (SPSS) programm has been used for the evaluation of the data. Furthermore, other statistical methods like median, standart deviation and Student Test were used. Qualitative data were analised by chi-square test, and Fisher's Exact chi-square test. ODDS risk analising system is used. Results were evaluated in the intervall of 95% and the significancy at (p<0.05). Nosocomial pneumonia is detected in 33.3% of the patients, who were transferred to the Intensive Care Unit of the Emergency Surgery Department. According to the results achieved in this study, conditions such as, blunt trauma, low Glaskow Coma Index (GCI<9), high trauma severety score ( ISS>30), prolonged stay in Intensive Care Unit, prolonged ventilation, prolonged endotracheal entubation, prolonged antibiotic therapy, tracheostomy, nasogastric intubation, monitorisation of the intracerebral pressure, brain surgery, use of sedatives, enteral feeding are significant risc factors (p<0.05). Trauma, Nosocomial pneumonia, Intensive Care Unit,