Year 2020, Volume 4 , Issue 6, Pages 491 - 495 2020-06-01

Koroner bypass cerrahisi uygulanan geriatrik ve geriatrik olmayan hastalarda preoperatif risk puanlama sistemlerinin değerlendirilmesi
Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients

Hakan KARTAL [1] , Hüseyin SİCİM [2] , Ufuk MUNGAN [3] , Ertan DEMİRDAŞ [4] , Gökhan EROL [5] , Arslan OCAL [6] , Murat KOÇ [7]


Amaç: Kalp cerrahisi uygulanacak olan hastalarda mortaliteyi öngörmeye duyulan ihtiyacın sonunda birçok preoperatif risk skorlama sistemleri oluşturulmuştur. Günümüzde de bu preoperatif skorlama sistemleri başarıyla kullanılmaktadır. Skorlama sistemleri kriterlerinde hasta yaşını risk faktörü olarak kullansada, bu sistemlerin alt gruplarında da etkinliklerinin değerlendirilmesi gerekmektedir.
Yöntemler: Retrospektif kohort çalışmamızda Özel Akay Hastanesi Kalp ve Damar Cerrahisi Kliniği’nde Mayıs 2012 – Mart 2014 tarihleri arasında ardışık olarak CPB altında izole CABG operasyonu geçiren tüm hastalar çalışmaya dâhil edildi. Hastalar geriatrik (≥65 yaş) ve geriatrik olmayan (<65 yaş) hastalar olmak üzere iki gruba ayrıldı. Çalışmamızda meydana gelen intraoperative ve postoperatif 30 gün içinde olan ölümler mortalite olarak kabul edildi. Retrospektif olarak hastalara ait demografik veriler, preoperatif risk faktörleri, preoperatif tedaviler, postoperatif veriler, postoperatif komplikasyonlar, laboratuar bulguları, gözlenen mortalite ve morbidite kayıtları hasta dosyaları ve hastane veri tabanından elde edilmiştir.
Bulgular: Altmış beş yaş üzerindeki hastalar için Euroscore 2 beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %93 olduğu, 65 yaş altındaki hastalar için Euroscore 2 beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %78 olduğu izlenmiştir (P=0,01). Altmış beş yaş üzerindeki hastalar için Logistic Euroscore (Log Euroscore) beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %94 olduğu, altmış beş yaş altındaki hastalar için Log Euroscore beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %77 olduğu izlenmiştir (P=0,01). Altmış beş yaş üzerindeki hastalar için Logistic Parsonnet (Log Parsonnet) beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %89 olduğu, altmış beş yaş altındaki hastalar için Log Pars beklenen mortalitenin gerçekleşen mortaliteye göre uyum düzeyinin %71 olduğu izlenmiştir (P=0,01).
Sonuç: Genel olarak bakıldığında Euroscore 2, Log Euruscore ve Log Parsonnet skorlarlama sistemlerinin koroner bypass olacak geriatrik hastalar üzerinde mortalitenin belirlenmesinde daha etkin sonuçlar verdiği görülmüştür.

Aim: The need to predict mortality in patients undergoing cardiac surgery has resulted in the development of numerous preoperative risk scoring systems, which are being successfully implemented in clinical practice. Although the criteria of scoring systems use patient age as a risk factor, their effectiveness should also be evaluated in the subgroups of these systems.
Methods: Our retrospective cohort study includes all patients who underwent isolated CABG surgery at Private Akay Hospital Cardiovascular Surgery Clinic between May 2012 and March 2014. Patients were subdivided into two cohorts as geriatric (≥65 years) and non-geriatric (<65 years) patients. In this study, intraoperative deaths and deaths within 30 days postoperatively were considered as mortality. We retrospectively evaluated demographic data, preoperative risk factors, preoperative treatments, postoperative data, postoperative complications, laboratory findings, and mortality and morbidity outcomes from patient files and the hospital database.
Results: The coherence between observed and EuroSCORE II-predicted mortality, logistic Euro-SCORE-predicted mortality and Parsonnet-predicted mortality were 93%, 94%, and 89%, respectively for patients aged 65 and older, and 78%, 77%, and 71%, respectively for patients aged below 65 years (P=0.01 for all).
Conclusion: In general, we observed that EuroSCORE II, Log EuroSCORE and Log Parsonnet scoring systems are more effective in predicting mortality among elderly coronary bypass surgery patients compared to younger patients.
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Primary Language en
Subjects Surgery
Journal Section Research article
Authors

Orcid: 0000-0003-4539-0228
Author: Hakan KARTAL (Primary Author)
Institution: Gülhane Eğitim ve Araştırma Hastanesi
Country: Turkey


Orcid: 0000-0003-3430-3862
Author: Hüseyin SİCİM
Institution: ANKARA T.C. SB. SBÜ. GÜLHANE EĞİTİM VE ARAŞTIRMA HASTANESİ
Country: Turkey


Orcid: 0000-0003-0812-2654
Author: Ufuk MUNGAN
Institution: LOKMAN HEKİM ÜNİVERSİTESİ, TIP FAKÜLTESİ
Country: Turkey


Orcid: 0000-0002-7854-3481
Author: Ertan DEMİRDAŞ
Institution: ANKARA T.C. SB. SBÜ. GÜLHANE EĞİTİM VE ARAŞTIRMA HASTANESİ
Country: Turkey


Orcid: 0000-0003-4632-2606
Author: Gökhan EROL
Institution: ANKARA T.C. SB. SBÜ. GÜLHANE EĞİTİM VE ARAŞTIRMA HASTANESİ
Country: Turkey


Orcid: 0000-0002-9971-1974
Author: Arslan OCAL
Institution: ANKARA T.C. SB. SBÜ. GÜLHANE EĞİTİM VE ARAŞTIRMA HASTANESİ
Country: Turkey


Orcid: 0000-0003-4555-2151
Author: Murat KOÇ
Institution: ANKARA DR. SAMİ ULUS KADIN DOĞUM ÇOCUK SAĞLIĞI VE HASTALIKLARI SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Country: Turkey


Supporting Institution YOK
Dates

Publication Date : June 1, 2020

Bibtex @research article { josam744784, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2020}, volume = {4}, pages = {491 - 495}, doi = {10.28982/josam.744784}, title = {Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients}, key = {cite}, author = {Kartal, Hakan and Si̇ci̇m, Hüseyin and Mungan, Ufuk and Demi̇rdaş, Ertan and Erol, Gökhan and Ocal, Arslan and Koç, Murat} }
APA Kartal, H , Si̇ci̇m, H , Mungan, U , Demi̇rdaş, E , Erol, G , Ocal, A , Koç, M . (2020). Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients . Journal of Surgery and Medicine , 4 (6) , 491-495 . DOI: 10.28982/josam.744784
MLA Kartal, H , Si̇ci̇m, H , Mungan, U , Demi̇rdaş, E , Erol, G , Ocal, A , Koç, M . "Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients" . Journal of Surgery and Medicine 4 (2020 ): 491-495 <http://jsurgmed.com/en/pub/issue/54767/744784>
Chicago Kartal, H , Si̇ci̇m, H , Mungan, U , Demi̇rdaş, E , Erol, G , Ocal, A , Koç, M . "Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients". Journal of Surgery and Medicine 4 (2020 ): 491-495
RIS TY - JOUR T1 - Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients AU - Hakan Kartal , Hüseyin Si̇ci̇m , Ufuk Mungan , Ertan Demi̇rdaş , Gökhan Erol , Arslan Ocal , Murat Koç Y1 - 2020 PY - 2020 N1 - doi: 10.28982/josam.744784 DO - 10.28982/josam.744784 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 491 EP - 495 VL - 4 IS - 6 SN - -2602-2079 M3 - doi: 10.28982/josam.744784 UR - https://doi.org/10.28982/josam.744784 Y2 - 2020 ER -
EndNote %0 Journal of Surgery and Medicine Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients %A Hakan Kartal , Hüseyin Si̇ci̇m , Ufuk Mungan , Ertan Demi̇rdaş , Gökhan Erol , Arslan Ocal , Murat Koç %T Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients %D 2020 %J Journal of Surgery and Medicine %P -2602-2079 %V 4 %N 6 %R doi: 10.28982/josam.744784 %U 10.28982/josam.744784
ISNAD Kartal, Hakan , Si̇ci̇m, Hüseyin , Mungan, Ufuk , Demi̇rdaş, Ertan , Erol, Gökhan , Ocal, Arslan , Koç, Murat . "Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients". Journal of Surgery and Medicine 4 / 6 (June 2020): 491-495 . https://doi.org/10.28982/josam.744784
AMA Kartal H , Si̇ci̇m H , Mungan U , Demi̇rdaş E , Erol G , Ocal A , Koç M . Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients. J Surg Med. 2020; 4(6): 491-495.
Vancouver Kartal H , Si̇ci̇m H , Mungan U , Demi̇rdaş E , Erol G , Ocal A , Koç M . Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients. Journal of Surgery and Medicine. 2020; 4(6): 491-495.