{"id":747,"date":"2026-01-20T15:50:31","date_gmt":"2026-01-20T12:50:31","guid":{"rendered":"https:\/\/tatd.org.tr\/geriatri\/?p=747"},"modified":"2026-01-20T15:51:34","modified_gmt":"2026-01-20T12:51:34","slug":"2024-yilinin-ilgi-ceken-geriatrik-makaleleri","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/geriatri\/akademik-blog-yazisi\/2024-yilinin-ilgi-ceken-geriatrik-makaleleri\/","title":{"rendered":"2024 Y\u0131l\u0131n\u0131n \u0130lgi \u00c7eken Geriatrik Makaleleri"},"content":{"rendered":"\n

Yazar: Do\u00e7.Dr. Vahide Asl\u0131han DURAK <\/strong>\u00a0Edit\u00f6r: Prof. Dr. \u00d6zg\u00fcr Karc\u0131o\u011flu<\/strong><\/strong><\/p>\n\n\n\n

*Aral\u0131k 2024\u2019de yaz\u0131lan bu blog yaz\u0131s\u0131 teknik sorunlar nedeni ile Ocak 2026\u2019da yay\u0131nlanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Ya\u015fl\u0131 n\u00fcfusun giderek artmas\u0131 ve D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fcn\u00fcn ya\u015fl\u0131l\u0131k tan\u0131mlamas\u0131n\u0131 de\u011fi\u015ftirmesi \u00fczerine geriatri\/gerontoloji alanlar\u0131 daha da ilgi \u00e7ekici olup her y\u0131l daha fazla akademik ara\u015ft\u0131rma yap\u0131l\u0131r hale gelmi\u015ftir. Bu yaz\u0131m\u0131zda 2024 y\u0131l\u0131n\u0131n en ilgi \u00e7ekici ve biz acil servis hekimlerinde de bu alanda bir fark\u0131ndal\u0131k yaratmas\u0131 hedeflenen makaleleri yer almaktad\u0131r.<\/p>\n\n\n\n

1-Developing a prediction model for cognitive impairment in older adults following critical illness. BMC Geriatr<\/em>. 2024;24(1):982. <\/strong><\/p>\n\n\n\n

Bu \u00e7al\u0131\u015fmada yo\u011fun bak\u0131m yat\u0131\u015flar\u0131 sonras\u0131 sa\u011f kalan hastalarda yeni geli\u015fen veya k\u00f6t\u00fcle\u015fen hasarlar\u0131n tespit edilmesinin \u00f6nemi vurgulanmakta ve kognitif bozukluklar\u0131n yo\u011fun bak\u0131m yat\u0131\u015f\u0131 sonras\u0131 erken d\u00f6nemde tespit edilmesi i\u00e7in hastalar\u0131n elektronik sa\u011fl\u0131k kay\u0131tlar\u0131n\u0131n kullan\u0131ld\u0131\u011f\u0131 bir tarama modeli geli\u015ftirilmesi ama\u00e7lanmaktad\u0131r.<\/p>\n\n\n\n

2015-2021 y\u0131llar\u0131 aras\u0131nda yo\u011fun bak\u0131ma yat\u0131\u015f\u0131 ve taburculu\u011fu yap\u0131lan, minimum 48 saat kalan, 60 ya\u015f ve \u00fczeri hastalar dahil edilmi\u015f olup, \u00f6ncesinde demans tan\u0131s\u0131 olan hastalar ise \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131lm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

\u00d6ncesinde demans veya kognitif bozuklu\u011fu olmayan hastalarda yo\u011fun bak\u0131mdan taburculuk sonras\u0131 12 ay i\u00e7inde yeni tan\u0131 alanlar\u0131 saptamak veya yat\u0131\u015f \u00f6ncesi kognitif bozuklu\u011fu olanlarda yeni demans tan\u0131s\u0131 alanlar\u0131 saptamak \u00e7al\u0131\u015fman\u0131n esas hedefidir.<\/p>\n\n\n\n

Analizler i\u00e7in \u00e7e\u015fitli modeller kullan\u0131lm\u0131\u015f ve validasyon metodu olarak da Monte Carlo \u00e7apraz validasyon metodu tercih edilmi\u015ftir.<\/p>\n\n\n\n

Verilerin analizinde 8299 hastan\u0131n dahil edildi\u011fi ortalama ya\u015f\u0131n 72 oldu\u011fu ve %44,8 oran\u0131nda kad\u0131n hasta oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Mortalite oran\u0131 bir y\u0131l i\u00e7in %22 olarak saptanm\u0131\u015ft\u0131r. Taburculuk sonras\u0131 1 y\u0131l i\u00e7inde demans veya kognitif bozukluk alma tan\u0131s\u0131 i\u00e7in k\u00fcm\u00fclatif insidans ise %5 olarak saptanm\u0131\u015ft\u0131r. Demans \/ kognitif bozukluk geli\u015fen grupta; kad\u0131n cinsiyet, ileri ya\u015f, partnerin olmamas\u0131 (bo\u015fanm\u0131\u015f, bekar, dul, kay\u0131p) ve taburculuk sonras\u0131 bak\u0131m evine yerle\u015ftirilme oran\u0131 istatistiksel olarak anlaml\u0131 oranda y\u00fcksek saptanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Oblique random survival forest ( ORSF) denilen dijital bir sistemde d\u00fc\u015f\u00fck ve y\u00fcksek riskli hasta ayr\u0131m\u0131 en iyi \u015fekilde yap\u0131lm\u0131\u015f ve di\u011fer t\u00fcm modellerde c- istatistik oran\u0131 0,76 ile 0,83 aras\u0131nda saptanm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fmam\u0131zda tan\u0131 s\u00fcrecini belirleyen ana unsurlar; ya\u015f, ilk yat\u0131\u015f esnas\u0131nda deliryum olmas\u0131, taburculuk sonras\u0131 ilk 3 ayl\u0131k d\u00f6nemde sa\u011fl\u0131k hizmeti kullan\u0131m\u0131n\u0131n artmas\u0131 olarak belirlenmi\u015ftir.<\/p>\n\n\n\n

Literat\u00fcrde yer alan \u00e7al\u0131\u015fmalardan farkl\u0131 olarak; elektronik sa\u011fl\u0131k kay\u0131tlar\u0131n\u0131 kullanarak yeni tan\u0131 demans veya kognitif bozukluk saptayan ilk \u00e7al\u0131\u015fma bu \u00e7al\u0131\u015fma olup bu vakalar\u0131n bildirilmeme veya fark edilmeme oran\u0131n\u0131n y\u00fcksek oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr.<\/p>\n\n\n\n

2- The role of Ottawa ankle rules in geriatric emergency department visits. Ulus Travma Acil Cerrahi Derg. 2024;30(4):271-275. <\/strong><\/p>\n\n\n\n

Ayak bile\u011fi yaralanmalar\u0131 acil servis ba\u015fvurular\u0131nda \u00f6nemli bir yer tutmakta olup, erken tan\u0131 ve etkili tedavi y\u00f6ntemleri ile hastalar\u0131n k\u0131sa s\u00fcrede iyile\u015fmesi sa\u011flanmaktad\u0131r. Bu \u00e7al\u0131\u015fmada Ottawa Ayak Bile\u011fi kurallar\u0131n\u0131n geriatrik hasta pop\u00fclasyonu i\u00e7in etkinli\u011fini ara\u015ft\u0131rmak ama\u00e7lanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

\u015eubat 2022 ve Kas\u0131m 2022 aras\u0131nda acil servise izole ayak bile\u011fi yaralanmas\u0131 ile ba\u015fvuran ve 65 ya\u015f ve \u00fczeri olan 160 hasta \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir. Hastalar\u0131n %37,5 oran\u0131nda k\u0131r\u0131k saptanm\u0131\u015f ve Ottawa Ayak Bile\u011fi kurallar\u0131n\u0131n sensitivitesi %98,33, spesifitesi %86, negatif prediktif de\u011feri %98,85 ve pozitif prediktif de\u011feri ise %80,82 olarak saptanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Sonu\u00e7 olarak; Ottawa Ayak Bile\u011fi kurallar\u0131 gereksiz radyolojik g\u00f6r\u00fcnt\u00fcleme ve ileri tan\u0131 y\u00f6ntemlerinin \u00f6n\u00fcne ge\u00e7ebilmek i\u00e7in efektif bir ara\u00e7 olarak kullan\u0131labilmekte ancak baz\u0131 nadir k\u0131r\u0131k tiplerini atlayabilmektedir. Bu nedenle acil servis hekimleri; geriatrik pop\u00fclasyonda bu kurallar\u0131 uygularken mutlaka dikkatli bir muayene ve ki\u015fiselle\u015ftirilmi\u015f bir yakla\u015f\u0131m da eklemelidirler.<\/p>\n\n\n\n

3- Factors associated with serious abdominal conditions in geriatric patients visiting the emergency department. BMC Emerg Med<\/em>. 2024;24(1):16. <\/strong><\/p>\n\n\n\n

Kar\u0131n a\u011fr\u0131s\u0131 geriatrik hasta pop\u00fclasyonunun acil servis ba\u015fvurular\u0131nda %20 oranda g\u00f6r\u00fclmekte olup, ciddi morbidite ve mortalite nedeni olabilmektedir. Bu \u00e7al\u0131\u015fmada ciddi abdominal \u015fikayetlerle ili\u015fkili fakt\u00f6rlerin ortaya konmas\u0131 hedeflenmektedir.<\/p>\n\n\n\n

2017-2021 y\u0131llar\u0131 aras\u0131nda y\u00fcr\u00fct\u00fclen bu retrospektif \u00e7al\u0131\u015fmada 65 ya\u015f ve \u00fczeri olan ve acile akut abdominal a\u011fr\u0131 ile ba\u015fvuran hastalar \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir.<\/p>\n\n\n\n

1221 hastan\u0131n dahil edildi\u011fi \u00e7al\u0131\u015fmada; erkek cinsiyet, anoreksi, NEWS skoru 5-6, sistolik kan bas\u0131nc\u0131n\u0131n 100-125 mmHg olmas\u0131, bak\u0131m hastas\u0131 olmas\u0131, beyaz k\u00fcre de\u011ferinin \u2265 14,000 h\u00fccre \/mm3 <\/sup>olmas\u0131, acil serviste kal\u0131\u015f s\u00fcresinin 4-8 saat olmas\u0131 ve \u2265 8 s olmas\u0131n\u0131n ciddi abdominal durumlarla ili\u015fkili oldu\u011fu sonucuna var\u0131lm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

4- Standard imaging in the emergency department in geriatric patients with immobilizing pelvic pain after low-energy trauma or without trauma: X-ray vs. computed tomography. Injury<\/em>. 2024;55(3):111294. <\/strong><\/p>\n\n\n\n

Yaln\u0131zca r\u00f6ntgen ile de\u011ferlendirilen geriatrik hasta grubundaki pelvis yaralanmalar\u0131 s\u0131kl\u0131kla yanl\u0131\u015f s\u0131n\u0131fland\u0131r\u0131lmakta, hatta g\u00f6zden ka\u00e7abilmektedir. Buna ba\u011fl\u0131 olarak hastalarda; uzun s\u00fcreli immobilizasyon ve devaml\u0131 pelvik a\u011fr\u0131 g\u00f6r\u00fclebilmektedir. Bu \u00e7al\u0131\u015fman\u0131n amac\u0131 hareket etmeyi k\u0131s\u0131tlayan pelvik a\u011fr\u0131s\u0131 olan 70 ya\u015f ve \u00fczeri hastalarda radyografinin duyarl\u0131l\u0131\u011f\u0131n\u0131 ve \u00f6zg\u00fcll\u00fc\u011f\u00fcn\u00fc de\u011ferlendirmektir.<\/p>\n\n\n\n

Retrospektif olarak y\u00fcr\u00fct\u00fclen bu \u00e7al\u0131\u015fmaya travmatik veya travma d\u0131\u015f\u0131 nedenlerden dolay\u0131 hareket etmeyi k\u0131s\u0131tlayan pelvik a\u011fr\u0131s\u0131 olan 107 geriatrik grup hasta (23 erkek, 84 kad\u0131n) dahil edilmi\u015f olup ortalama ya\u015f 83,07 \u00b1 6,08 y\u0131l olarak saptanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Hastalardan 91\u2019inde pelvisin \u00f6n-arka (AP) grafisi ve ard\u0131ndan bilgisayarl\u0131 tomografisi (BT) \u00e7ekilmi\u015ftir.<\/p>\n\n\n\n

\u00c7al\u0131\u015fma grubunda AP Pelvik grafinin tan\u0131sal performans\u0131n\u0131n pelvis BT (alt\u0131n standart) ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda, (%2,7) duyarl\u0131l\u0131k ve (%94,4) \u00f6zg\u00fcll\u00fck ile sonu\u00e7lanm\u0131\u015f olup \u00e7al\u0131\u015fma pop\u00fclasyonunda pelvis k\u0131r\u0131klar\u0131na \u00f6zel duyarl\u0131l\u0131k (%3,4) ve \u00f6zg\u00fcll\u00fck (%94,4) saptanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Bu \u00e7al\u0131\u015fman\u0131n sonu\u00e7lar\u0131na g\u00f6re; AP Pelvik grafisi; d\u00fc\u015f\u00fck enerjili travma olan veya olmayan ve hareket k\u0131s\u0131tlay\u0131c\u0131 pelvik a\u011fr\u0131s\u0131 olan hastalarda ilk basamak g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemi olarak uygun olmad\u0131\u011f\u0131 sonucuna var\u0131lm\u0131\u015ft\u0131r ve bu hastalarda pelvis BT \u00e7ekilmesi gerekmektedir. \u00c7al\u0131\u015fma bu kapsamda hasta gruplar\u0131na g\u00f6re pelvis BT \u00e7ekilmesi i\u00e7in yeni tan\u0131sal algoritmalar\u0131n gereklili\u011fine dikkati \u00e7ekmektedir.<\/p>\n\n\n\n

5- Evaluation of the Early Administration of Tranexamic Acid in Geriatric Hip Fractures in the Emergency Department: A Retrospective Study. Cureus<\/em>. 2024;16(6):e62636. Published 2024 Jun 18. <\/strong><\/p>\n\n\n\n

Perioperatif traneksamik asit (TXA) uygulanmas\u0131, peritrokanterik kal\u00e7a k\u0131r\u0131\u011f\u0131 olan hastalarda hemoglobin seviyelerindeki postoperatif d\u00fc\u015f\u00fc\u015fleri ve transf\u00fczyon ihtiyac\u0131n\u0131 azaltmada etkili olarak kabul edilmektedir. Bu \u00e7al\u0131\u015fmada, acil serviste standart perioperatif TXA dozuna ek olarak TXA alan ve k\u0131r\u0131lganl\u0131\u011fa ba\u011fl\u0131 kal\u00e7a k\u0131r\u0131\u011f\u0131 olan hastalar\u0131n, acil serviste TXA almayan hastalarla kar\u015f\u0131la\u015ft\u0131rmak ve hemoglobin seviyesi \u00fczerindeki etkiyi de\u011ferlendirmek ama\u00e7lanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

\u00c7al\u0131\u015fma kapsam\u0131nda May\u0131s 2020 ile May\u0131s 2021 tarihleri \u200b\u200baras\u0131nda 2.D\u00fczey travma merkezinde iki gruba ayr\u0131lm\u0131\u015f 64 hasta kayd\u0131 retrospektif olarak incelenmi\u015f, hastalar acil serviste yaralanmadan sonraki be\u015f saat i\u00e7inde bir gram TXA alan hastalar (yeni protokol) veya acil serviste hi\u00e7 TXA almayan hastalar (eski protokol) olarak gruplanm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fman\u0131n primer sonucu hemoglobin d\u00fczeyi \u00f6l\u00e7\u00fcm\u00fc ve istenmeyen olaylar\u0131n saptanmas\u0131d\u0131r.<\/p>\n\n\n\n

Ameliyat g\u00fcn\u00fc veya s\u0131f\u0131r\u0131nc\u0131 g\u00fcn ile acil servise geli\u015f g\u00fcn\u00fcndeki hemoglobin de\u011feri aras\u0131ndaki fark \u00f6l\u00e7\u00fclm\u00fc\u015f ve bu iki protokol aras\u0131nda fark  istatistiksel olarak anlaml\u0131 bulunmam\u0131\u015ft\u0131r. (p=0,322). Ameliyat sonras\u0131 birinci g\u00fcn ile acil servise geli\u015fte g\u00fcn\u00fcndeki hemoglobin de\u011feri aras\u0131ndaki fark da istatistiksel olarak anlaml\u0131 bulunmam\u0131\u015ft\u0131r (p = 0,339). Yeni protokolde yan etki oran\u0131 daha d\u00fc\u015f\u00fck olsa da iki protokol aras\u0131nda istatistiksel olarak anlaml\u0131 farkl\u0131l\u0131k saptanmam\u0131\u015ft\u0131r (p = 0,178).<\/p>\n\n\n\n

K\u0131r\u0131lganl\u0131\u011fa ba\u011fl\u0131 geli\u015fen kal\u00e7a k\u0131r\u0131klar\u0131nda TXA kullan\u0131m\u0131n\u0131 destekleyen \u00e7al\u0131\u015fmalar literat\u00fcrde giderek artmakta ancak uygulanma zaman\u0131 ile ilgili yeterli k\u0131lavuz bulunmamaktad\u0131r. \u00c7al\u0131\u015fmam\u0131zda iki protokol aras\u0131nda istatistiksel olarak anlaml\u0131 farkl\u0131l\u0131k bulunmasa da erken d\u00f6nemde verilmesinin sonucunda yan etkilerin artmad\u0131\u011f\u0131 g\u00f6r\u00fclmekte ve bu sayede TXA\u2019n\u0131n g\u00fcvenli yan etki profili desteklenmektedir.<\/p>\n\n\n\n

6-The adherence of Turkish emergency departments to geriatric guideline recommendations. Eur Geriatr Med<\/em>. 2024;15(5):1267-1275.<\/strong><\/p>\n\n\n\n

Bu \u00e7al\u0131\u015fma, \u00fclkemizdeki acil servislerde geriatrik hastalara uygun protokollerin, ekipmanlar\u0131n ve fiziksel \u015fartlar\u0131n kullan\u0131labilirli\u011finin yan\u0131 s\u0131ra potansiyel iyile\u015ftirme \u00f6nerilerinin belirlenmesini ama\u00e7lamaktad\u0131r. Prospektif olarak y\u00fcr\u00fct\u00fclen bu anket \u00e7al\u0131\u015fmas\u0131 1-29 \u015eubat 2024 tarihleri \u200b\u200baras\u0131nda T\u00fcrkiye’deki AI, AII, B grubu ve \u00fcniversite hastanelerinde ger\u00e7ekle\u015ftirilmi\u015ftir.<\/p>\n\n\n\n

\u00c7al\u0131\u015fma; 75 kat\u0131l\u0131mc\u0131 ile ger\u00e7ekle\u015ftirilmi\u015f olup ayl\u0131k ya\u015fl\u0131 hasta ba\u015fvuru say\u0131s\u0131 500 ve \u00fczerinde olan hastane say\u0131s\u0131 133 (%76,0) olarak saptanm\u0131\u015ft\u0131r. Personel\/y\u00f6netim bilgisinin rehber \u00f6nerilerine g\u00f6re d\u00fc\u015f\u00fck d\u00fczeyde oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Personel\/hasta y\u00f6netim bilgisi ve toplam ekipman\/malzeme uygunlu\u011fu hastane t\u00fcrleri ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda \u00fcniversite hastanelerinin rehbere en uygun \u015fekilde hareket etti\u011fi ve gruplar aras\u0131 farkl\u0131l\u0131klar\u0131n anlaml\u0131 d\u00fczeyde oldu\u011fu belirlenmi\u015ftir (p\u2009<0,001).<\/p>\n\n\n\n

Sonu\u00e7 olarak; T\u00fcrkiye’deki acil servislerin, geriatrik acil servis k\u0131lavuzlar\u0131nda belirtilen kriterlere uyumunun olduk\u00e7a d\u00fc\u015f\u00fck d\u00fczeyde oldu\u011fu belirlenmi\u015f olup bu alanda iyile\u015ftirme politikalar\u0131n\u0131n uygulanmas\u0131 \u00f6nerilmektedir.<\/p>\n\n\n\n

7- Elderly patients with non-specific complaints at the emergency department have a high risk for admission and 30-days mortality. BMC Geriatr<\/em>. 2024;24(1):5. Published 2024 Jan 3. <\/strong><\/p>\n\n\n\n

Ya\u015fl\u0131 hastalar acil servis kaynaklar\u0131n\u0131n daha fazla kullan\u0131m\u0131n\u0131 gerektiren komplike t\u0131bbi \u015fikayetlerle ba\u015fvurabilmektedir. Non-spesifik \u015fikayetler, olumsuz sonu\u00e7lara yol a\u00e7ma ihtimal\u0131 \u00e7ok olsa da, \u00f6ncelikli olarak de\u011ferlendirilmemektedir. \u00c7al\u0131\u015fman\u0131n amac\u0131; dispne, g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 ve kar\u0131n a\u011fr\u0131s\u0131 gibi spesifik \u015fikayetlere k\u0131yasla acil servise non-spesifik \u015fikayetlerle ba\u015fvuran geriatrik hasta gruplar\u0131nda hastane yat\u0131\u015f\u0131 ve mortalite oranlar\u0131n\u0131 ara\u015ft\u0131rmakt\u0131r.<\/p>\n\n\n\n

Retrospektif olarak y\u00fcr\u00fct\u00fclen bu \u00e7el\u0131\u015fmada; hastalar\u0131n elektronik t\u0131bbi kay\u0131tlar\u0131ndan \u015fikayetleri incelenmi\u015ftir. Halsizlik, konf\u00fczyon, jeneralize g\u00fc\u00e7s\u00fczl\u00fck ve d\u00fc\u015fme riski non-spesifik \u015fikayet olarak belirlenmi\u015ftir. Hastalar\u0131n yat\u0131\u015f ve 30g\u00fcnl\u00fck mortalite oran\u0131 \u00e7al\u0131\u015fman\u0131n primer sonu\u00e7lar\u0131n\u0131 olu\u015fturmaktad\u0131r. Toplamda 4.927 hasta \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir ve ba\u015fvuru \u015fikayetlerine g\u00f6re kategorize edilmi\u015f olup g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 (%32), dispne (%27), kar\u0131n a\u011fr\u0131s\u0131 (%30) ve non-spesifik \u015fikayetler  (%11) oran\u0131nda saptanm\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Dispne ve non-spesifik \u015fikayetleri olan hastalar, s\u0131ras\u0131yla %79 ve %70 yat\u0131\u015f oranlar\u0131 ile en y\u00fcksek hastaneye yat\u0131\u015f oranlar\u0131na sahipken, g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 (%63) ve kar\u0131n a\u011fr\u0131s\u0131 (%61) olan hastalar daha d\u00fc\u015f\u00fck yat\u0131\u015f oranlar\u0131na sahiptir (p < 0,001).<\/p>\n\n\n\n

Non-spesifik \u015fikayetleri olan hastalar\u0131n acil serviste ortalama kal\u0131\u015f s\u00fcresi (4.7 saat) g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, dispne veya kar\u0131n a\u011fr\u0131s\u0131 olan hastalara k\u0131yasla anlaml\u0131 derecede daha uzundur.T\u00fcm hastalar i\u00e7in ortalama kal\u0131\u015f s\u00fcresi 4.2 g\u00fcnd\u00fcr. Ancak, non-spesifik \u015fikayetleri olan hastalar\u0131n hastanede kal\u0131\u015f s\u00fcresi ortalama 5.6 g\u00fcnd\u00fcr, bu da daha uzun bir hastaneye yat\u0131\u015f s\u00fcresine ihtiya\u00e7 duyduklar\u0131n\u0131 g\u00f6stermektedir.Hem non-spesifik \u015fikayetleri hem de dispne \u015fikayeti olan hastalar, en y\u00fcksek 30 g\u00fcnl\u00fck mortalite oranlar\u0131na sahipti.<\/p>\n\n\n\n

\u00c7al\u0131\u015fma, acil servise non-spesifik \u015fikayetler ile ba\u015fvuran ya\u015fl\u0131 hastalar\u0131n daha y\u00fcksek yat\u0131\u015f oranlar\u0131, daha uzun hastanede kal\u0131\u015f s\u00fcreleri ve daha y\u00fcksek 30 g\u00fcnl\u00fck mortalite riski ta\u015f\u0131d\u0131\u011f\u0131n\u0131 vurgulamakta olup acil servis personelinin bu hastalarla daha dikkatli olmas\u0131 \u00f6nerilmektedir.<\/p>\n\n\n\n

8- Risk of falls is associated with 30-day mortality among older adults in the emergency department. Am J Emerg Med<\/em>. 2024; 79:122-126. <\/strong><\/p>\n\n\n\n

Bu \u00e7al\u0131\u015fma, acil servise ba\u015fvuran ya\u015fl\u0131 bireylerde d\u00fc\u015fme riski ile 30 g\u00fcnl\u00fck mortalite aras\u0131ndaki ili\u015fkiyi incelemeyi ama\u00e7lam\u0131\u015ft\u0131r.75 ya\u015f ve \u00fczeri bireyleri kapsayan g\u00f6zlemsel bir kohort \u00e7al\u0131\u015fmas\u0131 olup acil servise ba\u015fvuran ve Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) kullan\u0131larak d\u00fc\u015fme riski de\u011ferlendirilen hastalar\u0131 kapsamaktad\u0131r. MEDFRAT, acil servise spesifik bir tarama arac\u0131d\u0131r. D\u00fc\u015fme riski, d\u00fc\u015f\u00fck (0-2 puan), orta (3-4 puan) veya y\u00fcksek (\u22655 puan) olarak s\u0131n\u0131fland\u0131r\u0131lm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fman\u0131n primer sonucu 30 g\u00fcnl\u00fck mortalitedir. Acil serviste d\u00fc\u015fme riski de\u011ferlendirilen toplam 941 hasta \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir. Ortalama  ya\u015f 83.7 olup; hastalar\u0131n %45.6’s\u0131 erkek olup %62.7’si hastaneye yatm\u0131\u015ft\u0131r. Y\u00fcksek d\u00fc\u015fme riski grubundaki 30 g\u00fcnl\u00fck mortalite, d\u00fc\u015f\u00fck risk grubunun d\u00f6rt kat\u0131 kadar bulunmu\u015ftur (%11.8 vs. %3.1; HR 4.00, %95 CI 2.18-7.34, p < 0.001). Orta risk grubundaki bireylerin mortalite oran\u0131, d\u00fc\u015f\u00fck risk grubunun neredeyse iki kat\u0131 kadar olup, bu fark istatistiksel olarak anlaml\u0131 bulunmam\u0131\u015ft\u0131r (%6.0 vs. %3.1; HR 1.98, %95 CI 0.91-4.32, p = 0.087).Sonu\u00e7 olarak; acil serviste yap\u0131lan d\u00fc\u015fme riski de\u011ferlendirmeleri, 30 g\u00fcnl\u00fck mortalite ile ili\u015fkili olup bu alanda yap\u0131lacak taramalar ile  ya\u015fl\u0131 bireylerin risk s\u0131n\u0131flamas\u0131 yap\u0131labilmektedir.<\/p>\n\n\n\n

KAYNAKLAR<\/strong><\/p>\n\n\n\n

1-Eisner AE, Witek L, Pajewski NM, et al. Developing a prediction model for cognitive impairment in older adults following critical illness. BMC Geriatr<\/em>. 2024;24(1):982. Published 2024 Nov 29.<\/p>\n\n\n\n

2- Seyhan AU, Ak R, \u015eim\u015fek F, Ayvac\u0131 S, A\u00e7\u0131kg\u00f6z O. The role of Ottawa ankle rules in geriatric emergency department visits. Geriatrik acil servis ba\u015fvurular\u0131nda Ottawa ayak bile\u011fi kurallar\u0131n\u0131n rol\u00fc. Ulus Travma Acil Cerrahi Derg<\/em>. 2024;30(4):271-275. <\/p>\n\n\n\n

3- Dadeh AA, Uppakarnnuntakul W. Factors associated with serious abdominal conditions in geriatric patients visiting the emergency department. BMC Emerg Med<\/em>. 2024;24(1):16. Published 2024 Jan 25. <\/p>\n\n\n\n

4- Abdalmaqsoud H, Sehmisch S, Giannoudis V, Liodakis E. Standard imaging in the emergency department in geriatric patients with immobilizing pelvic pain after low-energy trauma or without trauma: X-ray vs. computed tomography. Injury<\/em>. 2024;55(3):111294. <\/p>\n\n\n\n

5- Doka R, Neibaur S, Mohammad S, et al. Evaluation of the Early Administration of Tranexamic Acid in Geriatric Hip Fractures in the Emergency Department: A Retrospective Study. Cureus<\/em>. 2024;16(6):e62636. Published 2024 Jun 18. <\/p>\n\n\n\n

6- \u00c7elik \u015e, \u00c7elik P. The adherence of Turkish emergency departments to geriatric guideline recommendations. Eur Geriatr Med<\/em>. 2024;15(5):1267-1275. <\/p>\n\n\n\n

7- Erwander K, Ivarsson K, Olsson ML, Agvall B. Elderly patients with non-specific complaints at the emergency department have a high risk for admission and 30-days mortality. BMC Geriatr<\/em>. 2024;24(1):5. Published 2024 Jan 3. <\/p>\n\n\n\n

8- Hamilton MP, Bellolio F, Jeffery MM, et al. Risk of falls is associated with 30-day mortality among older adults in the emergency department. Am J Emerg Med<\/em>. 2024;79:122-126. <\/p>\n","protected":false},"excerpt":{"rendered":"

Yazar: Do\u00e7.Dr. Vahide Asl\u0131han DURAK \u00a0Edit\u00f6r: Prof. Dr. \u00d6zg\u00fcr Karc\u0131o\u011flu *Aral\u0131k 2024\u2019de yaz\u0131lan bu blog yaz\u0131s\u0131 teknik sorunlar nedeni ile Ocak 2026\u2019da…<\/p>\n","protected":false},"author":1185,"featured_media":748,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10014],"tags":[10020,10018],"class_list":["post-747","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi","tag-acil-tip","tag-geriatri"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/747","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/users\/1185"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/comments?post=747"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/747\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media\/748"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media?parent=747"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/categories?post=747"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/tags?post=747"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}