Koroner arter bypass cerrahisinin solid tümör öyküsü olan hastalarda mortalite ve morbiditeye etkileri
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koroner arter hastalığı (KAH) ateroskleroz nedeniyle koroner arterlerde daralma ya da tıkanma sonucu gelişen akut koroner sendrom (AKS) ve ölümle sonuçlanabilen bir kardiyovasküler hastalıktır. Çalışmamız 01/03/2021-01/06/2022 tarihleri arasında hastane otomasyon sistemi ve arşiv verileri kullanılarak, 2016-2020 yılları arasında Trakya Üniversitesi Kalp Damar Cerrahisi Anabilim Dalı'nda takipli olan 33'ü solid tümör öyküsü olan, 64'ü solid tümör öyküsü olmayan toplam 97 hastanın demografik verileri, klinik bulguları, laboratuvar testleri, mortalite durumları geriye dönük olarak incelenmiştir. Bu çalışmada postoperatif süreçte mortalite ve morbidite açısından solid tümörü bulunan ve bulunmayan hastaların sonuçlarının karşılaştırılarak mortalite ve morbidite etkilerinin araştırılması amaçlanmıştır. Hastalarımızın %76,29'u erkek olup en sık komorbidite varlığının %73,2 oranıyla hipertansiyon (HT) olduğu görüldü. %48,45'inin MI geçirdiği, %20,62'sinde sol ana koroner arter lezyonu olduğu, operasyonda %83,33'ünde LİMA kullanıldığı tespit edildi. Hastaların %31,96'sında postoperatif AF geliştiği gözlendi. Ayrıca hiçbir hastada yara yeri enfeksiyonu ve pace ihtiyacı gelişmediği saptandı. Hastaların %12,37'sinin 48 saatten uzun yoğun bakım ünitesinde (YBÜ) kaldığı ve %3'ünün de hayatını kaybettiği tespit edildi. Mortalite gelişen hastaların YBÜ'de 48 saatten uzun kalış oranı anlamlı olarak daha düşük saptandı. Mortalite gelişen hastalarda aort klemp zamanı daha kısa ve postoperatif yatış süresi daha uzun tespit edildi. Solid tömörü olmayan hastaların hiperlipidemi oranı, sigara kullanım oranı anlamlı olarak daha yüksek tespit edildi. Ayrıca solid tümör varlığı ile mortalite, komorbiditeler, sigara kullanımı, komplikasyonlar arasında anlamlı ilişki bulunamadı. 41 Sonuç olarak solid tümörlü kah tanısı olan hastalarda KABG cerrahisi uygulanmasının, izole kah tanısı olan hastalara KABG cerrahisi uygulanması ile benzer morbidite ve mortalite sonuçları ile yapılabileceği gözlemlenmiştir. Ancak mevcut çalışmadaki solid tm lü koroner arter hastalarının sayıca az miktarda olması nedeniyle hasta sayısının daha fazla olduğu, daha geniş çaplı hasta popülasyonu içeren ayrıntılı çalışmalara ihtiyaç vardır. Anahtar kelimeler: KAH, KABG, Mortalite, LİMA.
Coronary artery disease (CAD) is a cardiovascular disease that can result in acute coronary syndrome (ACS) and death, which develops as a result of narrowing or occlusion of the coronary arteries due to atherosclerosis. Our study was carried out by using hospital automation system and archive data between 01/03/2021 and 01/06/2022; demographic data, clinical findings, laboratory tests, and mortality status of a total of 97 patients, 33 with a history of solid tumor and 64 without a history of solid tumor, who were followed up in the Department of Cardiovascular Surgery of Trakya University between 2016-2020 were retrospectively analyzed. In this study, it was aimed to investigate the effects of mortality and morbidity by comparing the results of patients with and without solid tumors in terms of mortality and morbidity in the postoperative period. 76.29% of our patients were male and the most common comorbidity was hypertension (HT) with a rate of 73.2%.It was determined that 48.45% had MI, 20.62% had a left main coronary artery lesion, and 83.33% used LIMA. Postoperative AF was observed in 31.96% of the patients. In addition, it was determined that wound infection and the need for pacing did not develop in any of the patients. It was determined that 12.37% of the patients stayed in the intensive care unit (ICU) for more than 48 hours and 3% died. The rate of staying longer than 48 hours in the ICU was found to be significantly lower in patients who developed mortality. 43 Aortic clamp time was shorter and postoperative hospital stay was longer in patients who developed mortality. Hyperlipidemia rate and smoking rate were found to be significantly higher in patients without solid tumors. In addition, no significant relationship was found between the presence of solid tumors and mortality, comorbidities, smoking and complications. As a result, it has been observed that CABG surgery in patients with a diagnosis of CAD with solid tumors can be performed with similar morbidity and mortality results as CABG surgery in patients with a diagnosis of isolated CAD. However, due to the small number of coronary artery patients with solid tumors in the current study, there is a need for detailed studies involving a larger patient population with a larger number of patients. Keywords: CAD, CABG, Mortality, LIMA.
Coronary artery disease (CAD) is a cardiovascular disease that can result in acute coronary syndrome (ACS) and death, which develops as a result of narrowing or occlusion of the coronary arteries due to atherosclerosis. Our study was carried out by using hospital automation system and archive data between 01/03/2021 and 01/06/2022; demographic data, clinical findings, laboratory tests, and mortality status of a total of 97 patients, 33 with a history of solid tumor and 64 without a history of solid tumor, who were followed up in the Department of Cardiovascular Surgery of Trakya University between 2016-2020 were retrospectively analyzed. In this study, it was aimed to investigate the effects of mortality and morbidity by comparing the results of patients with and without solid tumors in terms of mortality and morbidity in the postoperative period. 76.29% of our patients were male and the most common comorbidity was hypertension (HT) with a rate of 73.2%.It was determined that 48.45% had MI, 20.62% had a left main coronary artery lesion, and 83.33% used LIMA. Postoperative AF was observed in 31.96% of the patients. In addition, it was determined that wound infection and the need for pacing did not develop in any of the patients. It was determined that 12.37% of the patients stayed in the intensive care unit (ICU) for more than 48 hours and 3% died. The rate of staying longer than 48 hours in the ICU was found to be significantly lower in patients who developed mortality. 43 Aortic clamp time was shorter and postoperative hospital stay was longer in patients who developed mortality. Hyperlipidemia rate and smoking rate were found to be significantly higher in patients without solid tumors. In addition, no significant relationship was found between the presence of solid tumors and mortality, comorbidities, smoking and complications. As a result, it has been observed that CABG surgery in patients with a diagnosis of CAD with solid tumors can be performed with similar morbidity and mortality results as CABG surgery in patients with a diagnosis of isolated CAD. However, due to the small number of coronary artery patients with solid tumors in the current study, there is a need for detailed studies involving a larger patient population with a larger number of patients. Keywords: CAD, CABG, Mortality, LIMA.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Göğüs Kalp ve Damar Cerrahisi, Thoracic and Cardiovascular Surgery
