Pulmoner tromboemboli sıklığı ve mortalitesinin meteorolojik parametreler ile ilişkisi
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Tarih
2009
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kardiyovasküler olayların kronobiyolojik olarak gözlendiği birçok çalışma ile ispatlanmıştır. Özellikle akut miyokart infarktüsü, ani kardiyak ölüm, aort diseksiyonu, stroke, retinal ven oklüzyonu ve derin ven trombozunun kronobiyolojik varyasyon gösterdiği saptanmıştır. Bununla birlikte pulmoner tromboemboli gelişimi üzerine meteorolojik faktörlerin etkisi birçok ülkede farklı iklim koşullarında araştırılmış ve farklı sonuçlar elde edilmiştir. 01/05/2001 ile 31/04/2008 tarihlerini kapsayan yedi yıllık dönemde, Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Kliniği tarafından yatırılarak akut pulmoner tromboemboli tanısı konmuş 234 hastanın verileri retrospektif olarak incelendi. Pulmoner tromboemboli tanısı konan hastalar, massif pulmoner tromboemboli ve nonmassif pulmoner tromboemboli hastaları olarak iki gruba ayrıldı. Hastaların demografik özellikleri, adresleri ve acil servise başvuru tarihleri kaydedildi. Bu veriler doğrultusunda; hastaların başvuru tarihinden önceki üç günlük, yedi günlük ve başvuru ayına ait basınç, sıcaklık ve nem değerleri tespit edilerek ortalaması alındı. SPSS 15 programı ile analiz edildi. Tanımlayıcı istatistik, Kolmogorov-Smirnov testi, X2 testi, korelasyon analizi ve bağımsız örneklerde T testi uygulandı. p<0.05 değerleri istatistiksel olarak anlamlı kabul edildi. Çalışmaya alınan 234 hastanın 121'i erkek, 113'ü kadındı. Hastaların yaş ortalaması 59.43±15.9 olup en büyüğü 93 en küçüğü 19 yaşındaydı. Mevsimlere göre hasta dağılımına bakıldığında en fazla hastanın ilkbahar mevsiminde (n=67), en az hastanın sonbahar mevsiminde (n=47) takip edildiği saptandı. Aylara göre hasta dağılımı incelendiğinde en çok hastanın mart ayında (n=28), en az hastanın kasım ayında (n=12) takip edildiği saptandı. Hastaların görülme sıklığı ile basınç, sıcaklık ve nem değerleri karşılaştırıldığında; basıncın düştüğü dönemlerde hasta sayısı daha fazla bulundu. Hastaların mevsimlere göre mortalite oranları karşılaştırıldığında; yaz mevsiminde mortalite oranının en yüksek (n=12), aylara göre mortalite oranları karşılaştırıldığında; ağustos ayında en yüksek (n=5) olduğu saptandı. Basınç, sıcaklık, nem değerleri ile hasta sayısı ve mortalite oranları karşılaştırıldığında; basıncın düşük olduğu dönemde hasta sayısında artış olduğu, mortalitenin ise üç günlük, yedi günlük, bir aylık basınç ve üç günlük nem değerlerinin düşük olduğu dönemde arttığı saptandı. Massif ve nonmassif pulmoner tromboemboli gelişimi üzerine basınç, sıcaklık ve nem değerlerinin etkisi saptanmadı. Massif pulmoner tromboemboliden ölümlerin olduğu dönemde ortalama aylık basınç değerlerinin; bununla birlikte nonmassif pulmoner tromboemboliden ölümlerin olduğu dönemde ise ortalama üç günlük basınç değerlerinin düşük olduğu saptandı. Sonuç olarak; pulmoner tromboemboli gelişiminin mevsimlere ve aylara göre farklılık gösterdiği, pulmoner tromboemboli gelişimi üzerine barometrik basıncın, mortalite üzerine barometrik basınç ve nemin etkisi olduğu saptandı.
Abstract
In many studies it has been proved that cardiovascular events are seen choronobiologically. It has been found that especially acute myocardial infacrtion, sudden cardiac death, aorta dissection, stroke, retinal vein occlusion and deep vein thrombosis display chronobiological variations. Furthermore, the effect of meteorological factors on pulmonary thromboembolism development has been investigated in many countries under different climatic conditions and different results have been achieved. The findings of 234 patients, who were hospitalized by Chest Clinic of Trakya University Hospital with a diagnosis of acute pulmonary thromboembolism between 01.05.2001 and 31.04.2008, were analyzed retrospectively. Patients with pulmonary thromboembolism were divided into two groups as massive pulmonary thromboembolism and non-massive pulmonary thromboembolism patients. The demographical characteristics, addresses and dates of presentation to the emergency service were recorded. According to these data the pressure, temperature and humidity values for the three and seven days before the admission to hospital and those values belonging to the month in which the patient came to the hospital were found and their averages were taken. They were analyzed with SPSS 15 program. Descriptive statistics, Kolmogorov-Smirnov test, X2 test, correlation analysis and T test with independent samples were applied. p<0.05 values were accepted statistically significant. Of 234 patients in the study, 121 were male and 113 were female. The oldest patient was 93, the youngest one was 19 years old and the mean age was 59.43±15.9. When we looked at the distribution of patients according to seasons, we found that the highest number of patients were followed in spring (n=67) and the lowest number in autumn (n=47). The distribution of patients according to months showed that the highest number of patients were followed in March (n=28) and the lowest number in November (n=12). When the incidence of patients was compared with the values of pressure, temperature and humidity, more patients were observed in the periods when pressure was low. We compared the mortality rates according to seasons and saw that the mortality rate was the highest in summer (n=12), as for the months, the highest mortality rate was in August (n=5). When pressure, temperature and humidity values were compared with the number of patients and mortality rates, it was found that the number of patients increased when pressure was low and that mortality increased when pressure was low for three days, seven days, and one month and humidity values were low for three days. Pressure, temperature and humidity values did not have an effect on the development of massive and non-massive pulmonary thromboembolism. In the period that massive pulmonary thromboembolism was mortal the mean monthly pressure values were found low. In addition, when non-massive pulmonary thromboembolism was mortal the mean pressure rates for three days were low. Consequently, we found that pulmonary thromboembolism development shows variations according to seasons and months and that pulmonary thromboembolism development is affected by barometric pressure and mortality is affected by barometric pressure and humidity.
Abstract
In many studies it has been proved that cardiovascular events are seen choronobiologically. It has been found that especially acute myocardial infacrtion, sudden cardiac death, aorta dissection, stroke, retinal vein occlusion and deep vein thrombosis display chronobiological variations. Furthermore, the effect of meteorological factors on pulmonary thromboembolism development has been investigated in many countries under different climatic conditions and different results have been achieved. The findings of 234 patients, who were hospitalized by Chest Clinic of Trakya University Hospital with a diagnosis of acute pulmonary thromboembolism between 01.05.2001 and 31.04.2008, were analyzed retrospectively. Patients with pulmonary thromboembolism were divided into two groups as massive pulmonary thromboembolism and non-massive pulmonary thromboembolism patients. The demographical characteristics, addresses and dates of presentation to the emergency service were recorded. According to these data the pressure, temperature and humidity values for the three and seven days before the admission to hospital and those values belonging to the month in which the patient came to the hospital were found and their averages were taken. They were analyzed with SPSS 15 program. Descriptive statistics, Kolmogorov-Smirnov test, X2 test, correlation analysis and T test with independent samples were applied. p<0.05 values were accepted statistically significant. Of 234 patients in the study, 121 were male and 113 were female. The oldest patient was 93, the youngest one was 19 years old and the mean age was 59.43±15.9. When we looked at the distribution of patients according to seasons, we found that the highest number of patients were followed in spring (n=67) and the lowest number in autumn (n=47). The distribution of patients according to months showed that the highest number of patients were followed in March (n=28) and the lowest number in November (n=12). When the incidence of patients was compared with the values of pressure, temperature and humidity, more patients were observed in the periods when pressure was low. We compared the mortality rates according to seasons and saw that the mortality rate was the highest in summer (n=12), as for the months, the highest mortality rate was in August (n=5). When pressure, temperature and humidity values were compared with the number of patients and mortality rates, it was found that the number of patients increased when pressure was low and that mortality increased when pressure was low for three days, seven days, and one month and humidity values were low for three days. Pressure, temperature and humidity values did not have an effect on the development of massive and non-massive pulmonary thromboembolism. In the period that massive pulmonary thromboembolism was mortal the mean monthly pressure values were found low. In addition, when non-massive pulmonary thromboembolism was mortal the mean pressure rates for three days were low. Consequently, we found that pulmonary thromboembolism development shows variations according to seasons and months and that pulmonary thromboembolism development is affected by barometric pressure and mortality is affected by barometric pressure and humidity.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Pulmoner Tromboemboli, Pulmonary Thromboembolism, Meteorolojik Faktörler, Meteorological Factors, Mortalite, Mortality
