Febril Nötropeni Yönetiminde Yatış Süresine Etki Eden Faktörlerin Değerlendirilmesi

Fatma YILMAZ, Buğra SAĞLAM, Merih REİS ARAS, Hacer Berna AFACAN ÖZTÜRK, Hafize Hilal ÇAYKÖYLÜ, Aylin Merve YAPICI GÜLÇİÇEK, Ahmet Kürşad GÜNEŞ, Murat ALBAYRAK
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Abstract

Aim: Febrile neutropenia (FEN) is one of the most serious and commonly seen complications of patients receiving chemotherapy for a diagnosis of hematological malignancy. FEN is an emergency condition with mortality rates reaching 40% because of an increase in antimicrobial-resistant pathogens in particular. In a situation with such high mortality rates, parameters that can predict prognosis play an important role in the approach to the patient. The aim of this study was to investigate the parameters that could affect prognosis in the follow-up of FEN. Material and Methods: The study included 58 patients hospitalised in the Hematology Clinic with a diagnosis of FEN. The patients were evaluated in respect of the recorded demographic characteristics, blood group, MASCC score, hemogram, procalcitonin, C-reactive protein (CRP), Interleukin-6 (IL-6), D-dimer, fibrinogen, pre-albumin, albumin, HbA1c, anthropometric measurements and length of stay in hospital. Results: According to the statistical analysis results, patients with a length of hospital stay of ≥14 days were determined to have a significant decrease in the MASCC score and thrombocyte count and the procalcitonin, Il-6, D-dimer values and the number of antibiotics used were higher. No significant difference was determined between the groups in respect of the other parameters. Conclusion: In the management of febrile neutropenia, the most important points are the establishment of indications for hospitalisation, rapid and early recognition of a worsening status and intervention made in the right place at the right time. Parameters with prognostic benefit will help the clinician in decision-making.
评估影响发热性中性粒细胞减少症住院治疗时间的因素
目的:发热性中性粒细胞减少症(FEN)是血液学恶性肿瘤化疗患者最严重、最常见的并发症之一。FEN是一种紧急情况,死亡率达到40%,特别是因为抗微生物药物耐药性病原体的增加。在死亡率如此之高的情况下,能够预测预后的参数在治疗患者的方法中起着重要作用。本研究的目的是探讨影响FEN随访预后的参数。材料和方法:本研究纳入了58例在血液学诊所诊断为FEN的住院患者。评估患者的人口学特征、血型、MASCC评分、血象、降钙素原、c反应蛋白(CRP)、白细胞介素-6 (IL-6)、d -二聚体、纤维蛋白原、白蛋白前、白蛋白、糖化血红蛋白、人体测量值和住院时间。结果:根据统计分析结果,住院时间≥14天的患者MASCC评分和血小板计数明显下降,降钙素原、Il-6、d -二聚体及抗生素使用次数较高。在其他参数方面,各组之间没有明显差异。结论:在发热性中性粒细胞减少症的治疗中,最重要的是确立住院指征,及早发现病情恶化,及时、及时地采取干预措施。对预后有利的参数有助于临床医生的决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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