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Giriş: COVID-19 pandemisinde hastalık, insandan insana bulaşma özelliği nedeniyle aile ve toplum yaşamını olumsuz etkilemiş, hızla yayılarak Acil Servis başvurularında aşırı bir artış oluşturmuştur. Transplantasyon yapılan hastalar gibi hassas hastaların bakımı da zor bir hal almıştır. Hem aile içindeki bulaş hem de toplum içindeki bulaş nedeniyle Acil Servislerde bu hassas hastaların bakımı, değerlendirilmesi, acil tanısı ve yatış kararı kritik öneme haizdir. Bu çalışmada amacımız; Acil servis başvurularının arttığı Covid-19 enfeksiyonu sürecinde Türkiye’de Solid organ nakilli hastaların başvuru sonuçlarının incelenmesidir. Metod: Girişimsel olmayan retrospektif gözlemsel dizayn edilen bu çalışmada; Mart 2020-Ocak 2021 tarihleri arasında Türkiye’de Covid-19 şüphesiyle hastaneye başvuran solid organ nakilli kişiler dahil edilmiştir. 14.463 olgunun Sağlık Bakanlığı bilgi sistemlerine kaydedilmiş klinik ve radyolojik parametreleri, servis ve yoğun bakım yatış ihtiyacı, yatış süreleri ve ölüm oranları incelenmiştir. Bulgular: Olguların %70,39’u (10.180) böbrek nakilli kişiler, %22’si (3245) karaciğer nakilli kişiler, %4,98’i (721) kalp nakli olmuş kişiler, %1,85’i (262) akciğer nakilliler, %0,21’ü (30) ince barsak nakilliler, %0,17’si (25) pankreas nakli olmuş kişilerden oluşuyordu. Tüm solid organ nakilli hastaların ortalama yatış oranı %86,7 idi. Solid organ nakilli hastalar değerlendirildiğinde COVID-19 tanısı konan 4307 hastanın %40,9’unda (1765) pnömoni saptandı, 1691’i (%39,2) hastaneye yatırılırken bu süre ortalama 10,08 gün idi. Yaş ortalamaları ise 48,83 ‘dü. Yoğun bakıma 448 (%10,4) vaka yatırıldı ve kalış süreleri 8,41 gün, ortalama yaşlarının da 57,4 ‘dü. COVID-19 tanısı alıp entübe olan solid organ nakilli hasta oranı %4,3 olup yatış süresi ortalama 7,6 gündü. Solid organ nakli olan tüm vakalarda toplam ölüm sayısı 318 (%2,19), ölenlerin yaş ortalaması 59,64 ‘du. COVID-19 tanısı almış tüm solid organ nakilli hastalarda ölüm oranı ise %7,38 olarak bulundu. Sonuç: COVID-19 pandemisi tibbi sosyal hizmetleri zorlaştırdığı göz önüne alındığında; Acil servislerde Solid organ nakli olan hastalar gibi hassas grupları izole etmenin, hızlı bir şekilde tanı ve yatış-taburcu kararı vermenin önemini ortaya koymaktadır. . Bu kararın; hem COVID-19 enfeksiyonunun sosyal hayatta hassas gruplarda yayılmasını azaltmada hem de enfeksiyon sonrası gelişebilecek pnömoni ve ötesi mortalitenin azaltılmasına katkı sağladığını, acil servislerde sosyal hizmet uygulamasının daha etkin olması için yeni önerilere ihtiyaç olduğunu düşünüyoruz.
Introduction: In the COVID-19 pandemic, the disease has negatively affected family and community life due to its characteristic of transmission from humans to humans, and has rapidly spread and created an excessive increase in emergency services applications. The care of sensitive patients, like transplanted patients, has become difficult. Due to both infection within the family and infection within the community, the care, evaluation, emergency diagnosis and hospitalization of these sensitive patients in emergency services are of critical importance. In this study, our goal is to study the application results of solid organ transplant patients in Turkey during the Covid-19 infection process, where emergency services applications are increased. Method: Non-entrepreneurial retrospective observation designed in this study; between March 2020 and January 2021 in Turkey with suspicion of Covid-19, solid organs transmitted persons were included. 14.463 incidents in the Ministry of Health information systems recorded clinical and radiological parameters, service and intensive care insert needs, insert times and mortality rates have been studied. The findings: 70.39% of the cases consisted of people with kidney transplant, 22% (3245) kidney transplant, 4.98% (721) heart transplant, 1.85% (262) lung transplant, 0.21% (30) thin abdominal transplant, and 0.17% (25) pancreas transplant. The average infection rate of all solid organs transplanted patients was 86.7%. When solid organs transmitted patients were evaluated, 40,9 percent (1765) of 4307 patients diagnosed with COVID-19 were diagnosed with pneumonia, 1691 (39.2 percent) were hospitalized, and this period was an average of 10,08 days. The average age was 48.83. In intensive care, 448 (10.4%) cases were deposited and the stay period was 8.41 days, and the average age was 57.4. COVID-19 diagnosed and entubated with solid organs transplanted patient ratio is 4.3%, and the average stay period is 7.6 days. In all cases with solid organ transplant, the total number of deaths was 318 (2.19%) and the average age of the dead was 59.64. In all patients with solid organ transplant diagnosed with COVID-19, the mortality rate was 7.38%. The COVID-19 pandemic has made social services more difficult; it demonstrates the importance of isolating sensitive groups, such as patients with solid organ transplant in emergency services, to quickly diagnose and make rescue decisions. . This decision has contributed to the reduction of the spread of COVID-19 infection in sensitive groups in social life and to the reduction of pneumonia and post-infection mortality, we think it needs new recommendations to make the application of social services in emergency services more effective.
Introduction: In the COVID-19 pandemic, the disease adversely affected family and community life due to its human-to-human transmission feature, spreading rapidly and creating an excessive increase in Emergency Service applications. Caring for sensitive patients, such as transplant patients, has also become difficult. Due to both family and community transmission, the care, evaluation, emergency diagnosis and hospitalization decision of these vulnerable patients are critical in the Emergency Departments. Our aim in this study is to examine the application results of solid organ transplant patients in Turkey during the Covid-19 infection period while emergency service applications are increasing.Method: In this non-invasive retrospective observational study; Between March 2020 and January 2021, solid organ transplant patients who applied to the hospital with the suspicion of Covid-19 in Turkey were included. The clinical and radiological parameters of 14,463 cases recorded in the information systems of the Ministry of Health, the need for hospitalization in the service and intensive care unit, length of stay and mortality rates were examined. Result: 70.39% (10.180) of the cases were kidney transplant recipients, 22% (3245) were liver transplant recipients, 4.98% (721) were heart transplant recipients, 1.85% (262) were lung transplant recipients , 0.21% (30) were small bowel transplant recipients, 0.17% (25) were pancreatic transplant recipients. The mean hospitalization rate of all solid organ transplant patients was 86.7%. When solid organ transplant patients were evaluated, pneumonia was detected in 40.9% (1765) of 4307 patients diagnosed with COVID-19, 1691 (39.2%) were hospitalized, with an average of 10.08 days. The mean age was 48.83. 448 (10.4%) cases were hospitalized in the intensive care unit, and their length of stay was 8.41 days and their mean age was 57.4 years. The rate of solid organ transplant patients diagnosed with COVID-19 and intubated was 4.3%, and the average length of stay was 7.6 days. The total number of deaths in all cases with solid organ transplantation was 318 (2.19%), and the mean age of those who died was 59.64 years. The mortality rate in all solid organ transplant patients diagnosed with COVID-19 was 7.38%. Conclusion: Considering that the COVID-19 pandemic complicates medical social services; It demonstrates the importance of isolating vulnerable groups such as patients with solid organ transplants in emergency departments and making a rapid diagnosis and hospitalization-discharge decision. We think that it contributes to both reducing the spread of COVID-19 infection in vulnerable groups in social life and reducing the post-infection pneumonia and beyond mortality, and that new recommendations are needed for more effective social work practice in emergency services.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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