Palyatif bak�m hastalar�nda bas� yaras� olu�umunu etkileyen fakt�rler

Usanma Koban, Bu�u; Tuzcular Vural, Emine Zeynep; Ozkaya, Hilal; G�nen�, I��k

Palyatif bak�m hastalar�nda bas� yaras� olu�umunu etkileyen fakt�rler [Haydarpasa Numune Med J]

Haydarpasa Numune Med J. Bask�daki Makaleler: HNHJ-81567

Palyatif bak�m hastalar�nda bas� yaras� olu�umunu etkileyen fakt�rler

Bu�u Usanma Koban¹, Emine Zeynep Tuzcular Vural², Hilal Ozkaya³, I��k G�nen�²
¹Hilmi �ahin Aile Sa�l�� Merkezi
²Haydarpa�a Numune E�itim ve Ara�t�rma Hastanesi
³Ba�ak�ehir �am ve Sakura �ehir Hastanesi

G�R�� ve AMA�: Bas� yaras� olu�mas�n� ve var olan yaran�n ilerlemesini engellemek a��s�ndan riskleri belirlenmek, mortaliteyi azaltmada olduk�a �nemlidir. �al��mam�zda, palyatif bak�m merkezinde yatan hastalarda bas� yaras� olu�mas�n� ve yara evresini etkileyen fakt�rleri belirlemek ama�lanm��t�r.
Y�NTEM ve GERE�LER: Kesitsel ve retrospektif olarak planlanm�� ara�t�rmam�z�n materyalini Ocak 2017 ve �ubat 2018 aras�nda palyatif bak�m merkezinde yatan hastalar olu�turmaktad�r. Hastalar�n ya�lar�, cinsiyetleri, primer tan�lar� ve komorbiditeleri kaydedilmi�tir; hemoglobin, hematokrit, lenfosit, n�trofil, C-reaktif protein, alb�min ve prealb�min de�erleri ve NRS 2002 skorlar� ile bas� yaras� bilgileri analiz edilmi�tir.
BULGULAR: Ara�t�rmam�za kat�lan hastalar�n 277�si kad�n (%55,1) 226's� erkektir (%44,9). Minimum ya� 21, maksimum ya� 96 olup ortalama 72,85 bulunmu�tur (72.85�15.36). Kad�n ve 65 ya� �zeri hastalarda bas� yaras� riski artmaktad�r. Serebrovask�ler olay ge�irmek veya demans/Alzheimer hastas� olmak ileri evre yara riskini artt�rmaktad�r. Hipertansiyon veya kardiyovask�ler hastal�k varl�� bas� yaras� riskini artt�rmaktad�r. Diyabet ve kronik b�brek hastal��n�n yara ile ili�kisi bulunmam��t�r. Alb�min, hemoglobin ve hematokrit d��kl�� ve lenfosit y�ksekli�i ileri evre yara ile ili�kilidir. Prealb�min, CRP, n�trofil ve n�trofil/lenfosit oran� ile bas� yaras� aras�nda anlaml� ili�ki bulunmam��t�r.
TARTI�MA ve SONU�: Bas� yaras� olu�umu ve ilerlemesi ile hastalar�n tan�lar�, beslenme durumu, anemi ve hipertansiyon varl�� aras�nda kuvvetli bir ili�ki vard�r. �leri ya�ta, kronik hastal��a sahip ve bak�m ihtiyac� olan hastalarda risklerin fark�nda olarak �nlem almak, morbidite ve mortalitenin �nlenmesi a��s�ndan b�y�k �nem ta��maktad�r.

Anahtar Kelimeler: Bas� yaras�, palyatif bak�m, beslenme

Factors effecting pressure sores in palliative care patients

Bu�u Usanma Koban¹, Emine Zeynep Tuzcular Vural², Hilal Ozkaya³, I��k G�nen�²
¹Hilmi �ahin Family Healthcare Center
²Haydarpa�a Numune Training and Research Hospital
³Ba�ak�ehir �am and Sakura City Hospital

INTRODUCTION: Determining the risks in terms of preventing the formation of pressure sores and the progression of the existing wound is very important in reducing mortality. In our study, we aimed to determine the factors affecting the formation of pressure ulcers and the stage of the wound in patients hospitalized in a palliative care center.
METHODS: The material of our cross-sectional and retrospective study consisted of patients hospitalized in a palliative care center between January 2017 and February 2018. The age, gender, primary diagnosis, comorbidities, hemoglobin, hematocrit, lymphocyte, neutrophil, C-reactive protein, albumin and prealbumin values and NRS 2002 scores of the patients were recorded; and the relationship of these variables with pressure ulcer information were analyzed.
RESULTS: Of the patients participating in our study, 277 (55.1%) were female and 226 (44.9%) were male. According to the results of our study, the risk of pressure ulcers increases in patients over 65 years of age and in female patients. Having a cerebrovascular accident or having dementia/Alzheimer's disease increases the risk of advanced wounds. Presence of hypertension or cardiovascular disease increases the risk of pressure ulcers. Diabetes and chronic kidney disease have not been found to be associated with wounds. Low albumin, hemoglobin and hematocrit and high lymphocyte levels are associated with advanced wounds. There was no statistically significant relationship between prealbumin, CRP, neutrophil levels, neutrophil/lymphocyte ratio and pressure ulcers.
DISCUSSION AND CONCLUSION: There is a strong relationship between the formation and progression of pressure ulcers and the diagnosis, nutritional status, presence of anemia and hypertension. Taking precautions by being aware of the risks in elderly patients with chronic diseases and in need of care is of great importance in terms of preventing pressure ulcers which increase morbidity and mortality.

Keywords: Pressure sore, palliative care, nutrition

Sorumlu Yazar: Bu�u Usanma Koban, T�rkiye
Makale Dili: �ngilizce

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