Διερεύνηση της συχνότητας εμφάνισης θρομβοεμβολικών επεισοδίων σε τραυματίες και νευροχειρουργικούς ασθενείς στη μονάδα εντατικής θεραπείας

Postgraduate Thesis uoadl:1310799 593 Read counter

Unit:
Κατεύθυνση Μονάδες Εντατικής Θεραπείας-Καρδιολογική Νοσηλευτική
Library of the School of Health Sciences
Deposit date:
2015-04-24
Year:
2015
Author:
Μαρκοπούλου Δήμητρα
Supervisors info:
Αναπληρωτής Καθηγητής Τούτουζας Κωνσταντίνος
Original Title:
Διερεύνηση της συχνότητας εμφάνισης θρομβοεμβολικών επεισοδίων σε τραυματίες και νευροχειρουργικούς ασθενείς στη μονάδα εντατικής θεραπείας
Languages:
Greek
Summary:
Venous thromboembolic disease is a major cause of morbidity and mortality among
patients hospitalized in Intensive Care Units despite preventive
anticoagulation therapy measures. In fact, pulmonary embolism is not only the
most serious manifestation of the disease but also one of the primary causes of
sudden death.
The aim of this study is to investigate the frequency of thromboembolism and
pulmonary embolism in the Intensive Care Unit hospitalized trauma and
neurosurgical patients.
Material and Method: We studied 100 ICU patients retrospectively, 51
postoperative neurosurgical and 49 trauma patients. The demographic data as
well as the medical history, temperature, white blood cells and platelets
levels of the patients on admission, the day of the thrombosis diagnosis and
the final outcome of their treatment were recorded.
The statistical package SPSS-19, the test T-test and x2-test were the means
used to extract statistical figures.
Results: The results indicated that 38 out of 100 patients presented
thrombosis, 14 trauma and 24 neurosurgical ones. Regarding the diagnosis, 49%
were trauma patients while 51% were postoperative neurosurgical patients, yet
all of them were hospitalized in the Intensive Care Unit. In addition, a 22.9%
of the sample suffered thrombosis on the first 5 days while the rate on the
10th day was escalated to 54.3%.A 15% suffered thrombosis in femoral vein, 5%
subclavian and 15% pulmonary embolism. Moreover, a 13% suffered thrombosis in
femoral veins due to central catheters, while for subclavian catheters the rate
was 3% . Up to 21 days was the ICU hospitalization for 60% of the sample.
Concerning the thrombosis diagnosis, 37.4% showed thrombosis in the femoral
vein, and 8.5% in the subclavian vein. Finally, no patients presented jugular
thrombosis.
The correlation of thrombosis was examined during hospitalization in tandem
with the diagnosis, the treatment allocated time and the overall patient
outcome. Thus, data analysis indicated that neurosurgical patients suffered
more frequent thrombosis than trauma patients (p <0,05). In connection with the
diagnosis, thrombosis was prevalent among patients with brain lesions (p =
0,018) while, regarding the type of the thrombosis, pulmonary embolism was also
commonly apparent among individuals with brain lesion (p = 0,020) .A
statistically significant correlation in thrombosis occurrence was found
between hospitalization day (p <0,01) and the final patients’ outcome (p
<0,001). The type of thrombosis was directly associated with poor outcome,
especially the one that resulted from central catheters (p <0,001) and
pulmonary embolism (p <0,001). However, it seems that it is not correlated to
temperature, the number of white blood cells and platelets during admission (p>
0,05) but to how pulmonary embolism is more related to death in the ICU (p =
0,017)

Conclusions: Thrombosis effects on hospitalized in the ICU patients’ final
outcome. The type of thrombosis contributes to poor outcomes and mainly the
occurrence of pulmonary embolism increases the mortality rate significantly.
Keywords:
Θρομβοεμβολική νόσος, Τραυματίες, Νευροχειρουργικοί ασθενείς
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
110
Number of pages:
87
File:
File access is restricted.

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