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ACİL SERVİSE SENKOP İLE BAŞVURAN HASTALARDA LABORATUAR İNCELEMELERİNİN KULLANIMI

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Syncope is one of the common presenting complaints in the emergency department population which makes up to 3% of the total cases. Many diagnostic tests have been devised to evaluate these patients. There are not any well-established protocols as to which tests should be performed in order to evaluate etiologic causes of syncope. As a result, these patients generally undergo routine laboratory screening tests. This study aims to describe demographic characteristics of the patients referred to Dokuz Eylül University ED with the chief complaint of syncope and to investigate the usefulness of the diagnostic tests used to evaluate these patients. Design.- We examined data charts of 798 patients with final diagnoses that could be related to syncope referred to the ED in between 24.04.1998 and 31.07.1998 retrospectively. 156 of the 798 patients were eligible. The majority of the patients were consisted of middle-aged women. The most common causes of syncope were revealed to be vasovagal and psychogenic factors. Cardiac syncope was most commonly diagnosed in elderly patients and 27.6% of the patients was idiopathic. Results.- We could not find any usefulness of commonly ordered diagnostic tests such as Na, K, Cl, creatinine, glucose, CK, LDH, AST, total bilirubin, direct bilirubin, amylase, urinary β- HCG, occult blood in stool and ABG regarding decision to admit and establishment of diagnosis of syncope. However, factors that predict admission of patients include EKG abnormalities, cardiovascular examination, cardiac monitoring, neurologic examination and cranial CT in patients with neurologic deficits. In addition, tests that may be beneficial in determining admission to hospital are CBC, BUN, Ca. Conclusion.- As a conclusion, future research could reveal efficiency of various laboratory tests ordered in routine work-up of syncope patients which may help cut down substantial healthcare expenses.
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Abstract (Original Language): 
Senkop acil servislerde sık karşılaşılan, başvuruların %3’ünü oluşturan tıbbi bir problemdir. Senkop geçiren hastaların değerlendirilmesi için bir çok test mevcuttur. Senkop tanısı için hangi testlerin yap ılacağına dair fikir birliği yoktur. Çoğu hekim bu tip hastalarda rutin laboratuar incelemeği yapmadan hastayı taburcu edememektedir. Bu çalışmada Dokuz Eylül Üniversitesi Hastanesi Acil Servisine senkop yakınmas ıyla başvuran hastaları demografik özelliklerine göre tanımlamak, hastaların değerlendirilmesinde kullanılan laboratuar testlerinin senkop tanısıyla ve hastanın sonucu (taburcu, yatış) ile olan ilişkisinin incelenmek ve hastaların acilde kalış sü- relerim etkileyen faktörleri belirlemek hedeflendi. Bu amaçla 24.4.1998 -31.7.1998 tarihleri arasında senkop tanısıyla müracat eden 156 hastanın dosyası incelendi. Hastalar ın %45.5’i erkek , %54.5’i kadındı ve yaş ortalamaları 44±18 olarak bulundu. Hastalar ın 43’ünde (%27.6) senkop nedeni bulunamam ıştı. Vazovagal-psikojenik nedenler senkopun en sık nedenleriydi (% 35.3). Kardiyak senkop düşünülen hastalar en yaşlı hastalardı. Senkop hastalarında sıkça istenen tetkiklerden; Sodyum, potasyum, klor, kreatinin, glikoz, laktat dehidrogenaz, aspartat transaminaz, kreatinin kinaz, total bilirubin, direkt bilirubin, amilaz, idrarda β−HCG, gaitada gizli kan ve kan gazı analizi hastaneye yatış ve senkop tan ışı koydurtma yönünden yararlı bulunmad ı. Elektrokardiografi, kardiyak bakı, nörolojik bakı ve bilgisayarlı beyin tomografisi (yalnızca nörolojik defisiti olan hastalarda) senkop tanısının konması ve has- taneye yatışta önemli belirleyiciler olarak bulundu. Tam kan sayımı, kan üre azotu ve kalsiyumun yatışı gereken senkop hastalar ım belirlemede yararlı olabileceği bulundu. Senkopta çeşitli testlerin ne kadar gerekli olduğunu ortaya koyabilecek ileriye yönelik araştırmalar planlanabilir ve bu şekilde önemli miktardaki sağlık bak ım harcamaları azaltılabilir.
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  • 2
82-88
  • Turkish

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