The Factors Associated To Mortality İn Acute Arterial Occlusions
Journal Name:
- Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi
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Keywords (Original Language):
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Abstract (2. Language):
Currently, acute arterial occlusion (AAO) incidence become increased and mortalitiy and morbidity rate ofthis pathology remained very high. The aim of retrospective study is to invastigate the factors which contributes the mortality rates among the patients which were admitted to our clinic with AAO. Between January 2003-November 2005 at the our clinic, one - hundred - three patients who had surgical interventions with acute arterial occlusion of upper and lower extremities were evaluated retrospectively. There were 60 male ( %58.3) and 43 female (%41.7) and mean age of the patients age was 67,86 + 12,09 (37 year and 95 year). Surgery was performed in 82 cases (%79.6) on lower extremity and in 21 cases (%20.4) on upper extremity. In our investigation only 82 patients ( %79.6) were operated with in 12 hours, the other 21 patients (%20.4) over 12 hours after after acute arterial occlusion. Localizations of the occlusion were femoropopliteal region in 76 cases (%73.7), brachial region in 21 cases (%20.3) and aortailiac region in 6 cases (%5.8), respectively. There were no re-embolectomy and extra vascular procedure performed in the patients which were operated for upper extremity problem. Re-embolectomy was performed on 17 (%20.7) of the patients which were operated for lower extremity problem for recurrence of the ischemic period. Extremity preservation rate was 92.2% (95 patients), mortality rate was 10.7% (11 patients). Mean age of the patients who occurred mortality was 73,63 + 7,31 (62-87) and eight patients was over seventy age. Statistically, there were not found any meaningful difference between cases which ending with mortality or not mortality groups (p>0.05) rate was 92.2% (95 patients), mortality rate was 10.7% (11 patients). Mean age of the patients who occurred mortality was 73,63 + 7,31 (62-87) and eight patients was over seventy age. Statistically, there were not found any meaningful difference between cases which ending with mortality or not mortality groups (p>0.05). Also statistically, there were not found any meaningful difference between cases which applying interference before 12 hours or after 12 hours ( p>0.05); but when they are comparised about amputation, there were found meaningful difference.(p<0.05). There is diagnosed coronary artery disease (CAD) on 10 cases (%90.9) and peripheral arterial disease (PAD) on 8 cases (%72.7) among the patients with mortality. And cases between ending with mortality or not, accompanying with coronary artery diseases, statistically serious meaningful difference determined(p<0.01) Acute arterial occlusion which is accompanied by coronary and peripheral arterial disease may result in high morbidity and mortality in clinical setting. Early intervention is beneficial in decreasing morbidity and mortality, therefore surgery must be performed as soon as possible in cases of AAO.
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Abstract (Original Language):
Günümüzde, akut arteryel tıkanıklık (AAT) yüksek morbidite ve mortalite ile seyretmektedir. Bu çalışmanın amacı, AAT ile kliniğimize başvuran olgularda mortaliteye eşlik eden faktörlerin değerlendirilmesidir. Ocak 2003 ile Kasım 2005 tarihleri arasında kliniğimizde AAT tanısıyla girişim uygulanan 103 olgu retrospektif olarak incelenmiştir. Olguların 60'ı erkek (% 58.3) ve 43'ü kadın (% 41.7) olup yaş ortalaması 67,86 + 12,09 (37-95) idi. Sekseniki olguda (%79.6) alt ekstremiteye, 21 olguda (%20.4) ise üst ekstremiteye yönelik cerrahi girişim uygulandı. Çalışmamızda olguların 82'ine (%79.6) AAT sonrası ilk 12 saat içerisinde, 21'sine (%20.4) ise 12. saatten sonra müdahale edildi. Tıkanıklık bölgesi sırasıyla 76 olguda (% 73,7) femoropopliteal, 21 olguda (%20.3) brakial ve 6 olguda aortailiak (% 5.8) bölge idi. Üst ekstremiteye yönelik girişim uygulanan olguların hiçbirine re-embolektomi ve ek cerrahi vasküler girişim uygulanmadı. Alt ekstremiteye yönelik girişim uygulanan olguların 17 'sinde (%20.7) iskeminin tekrar etmesi nedeniyle re-embolektomi uygulandı. Ekstremite kurtarma oranı 95 olgu ile %92.2, mortalite oranı ise 11 olgu ile %10.7 olarak gerçekleşti. Mortalite gelişen olguların yaş ortalaması 73,63 + 7,31 ( 62-87) olup, 8 olgu (%72.7) 70 yaş ve üzerindeydi. Mortalite gelişen olgular ile mortalite gelişmeyen olgular arasında yaş ortalaması bakımından istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Onikinci saatten önce ve 12. saatten sonra girişim uygulanan olgular arasında mortalite açısından istatistiksel olarak anlamlı fark bulunmadı (p>0.05), ancak amputasyon açısından karşılaştırıldığında istatistiksel olarak anlamlı fark bulundu (p<0.05). Mortalite gelişen olguların 10'unda (%90.9) koroner arter hastalığı (KAH), 8'in de (%72.7) periferik arter hastalığı (PAH) eşlik ettiği saptandı. Mortalite gelişen ve gelişmeyen olgular arasında eşlik eden KAH açısından istatistiksel olarak ciddi anlamlı fark saptandı (P<0.01). KAH ve PAH'nın eşlik ettiği ATT yüksek morbidite ve mortalite ile sonuçlanan klinik tablodur. Erken girişim morbidite ve mortaliteyi azaltabileceği için AAT gelişen olgulara en kısa zamanda girişimde bulunulmalıdır.
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