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Yıl:2013; Cilt: 50; Sayı: 1>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2013;50(1):40-44
Akut İskemik İnmede Mortalite ve Morbidite Belirteçleri
D Aksoy, A İnanır, M Ayan, B Çevik, S Kurt, HK Ünaldı
Gaziosmanpaşa Üniversitesi, Tokat
Amaç: İnme, tedavisindeki gelişmelere rağmen hala ciddi bir mortalite ve morbidite sebebidir. İnmenin erken döneminde hastanın ilk saatlerdeki nörolojik tablosu, görüntülemede saptanan lezyon büyüklüğü ve yaş en önemli prognostik faktörler olarak bilinmektedir. Bu çalışmada iskemik inmenin ilk saatlerinde glikoz, hemoglobin, hematokrit, beyaz küre (BK), ortalama eritrosit hacmi (Mean corpuscular volume: MCV), vitamin B12, folik asit, sedimantasyon gibi acil poliklinik şartlarında bakılabilecek, takip ve tedavi konusunda yönlendirici olabilecek prognostik belirteçlerin varlığını araştırdık. Yöntem: Bu retrospektif çalışmaya 2006-2011 yılları arasında hastanemize ilk 24 saat içinde başvuran 272 iskemik inmeli hasta alındı. Erken dönemdeki laboratuvar bulguları kaydedildi. Hastalar çıkış tarihlerindeki modifiye rankin skorlarına göre iyi ve kötü prognozlu grup olarak ikiye ayrıldı. Hastaların yaşları, laboratuvar sonuçları, hastanede kalış süreleri ve özgeçmişleri karşılaştırıldı. Bulgular: Hastalarımızda hipertansiyon inme risk faktörleri arasında ilk sırada idi. İyi ve kötü prognozlu gruplar arasında yaş, MCV, folik asit, BK ve sedimantasyon değerlerinde anlamlı farklılıklar vardı. Parametrelerin bağımsız değişkenler olarak lojistik regresyon analizi yapıldığında ileri yaş, yüksek MCV, düşük folik asit kötü prognozla anlamlı şekilde ilişkiliydi. Tartışma: İleri yaş inmede kötü pronozun en önemli belirtecidir. Yüksek MCV ve düşük folik asit düzeyleri de mortalite ve morbiditeyi etkilemişlerdir. Her iki parametre inme risk faktörlerinden biri olan hiperhomosisteinemi ile ilişkilidir. Dolayısıyla iskemik inmede erken dönemde homosistein, folik asit, vit B12, MCV düzeylerinin inme prognozuna etkisini araştıran prospektif çalışmalara ihtiyaç vardır.
Predictors of Mortality and Morbidity in Acute Ischemic Stroke
Objectives: Stroke, despite improvements in treatment is still a serious cause of

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