İzole Koroner Arter Bypass Greftleme Sonrası AHEAD Skoru ile Uzamış Yoğun Bakım Ünitesi Yatışı Arasındaki İlişki

Büşra GÜVENDİ ŞENGÖR; Mehmet ŞENGÖR; Muhammet Mucahit TİRYAKİ; Faruk AKALIN; Kadir BIYIKLI; Mustafa Ferhat KETEN; Cemalettin YILMAZ; Ünal AYDIN; Regayip ZEHİR

doi:10.14235/bas.galenos.2026.76743

ÖZ

Amaç

Koroner arter bypass greftleme (KABG) sonrası uzamış yoğun bakım ünitesi (YBÜ) yatışı; olumsuz klinik sonuçlar ve artmış sağlık hizmeti maliyetleri ile ilişkilidir. AHEAD skorunun çeşitli kardiyovasküler hastalıklarda prognostik değeri gösterilmiştir. Bu çalışmada AHEAD skoru ile uzamış YBÜ yatışı arasındaki ilişkinin değerlendirilmesi amaçlandı.

Yöntemler

Bu retrospektif iki merkezli çalışmaya Ocak 2020-Eylül 2025 tarihleri arasında izole KABG uygulanan 518 hasta dahil edildi. Uzamış YBÜ yatışı, 72 saatin üzerindeki yatış süresi olarak tanımlandı. Atriyal fibrilasyon, düşük hemoglobin düzeyi, ileri yaş, anormal böbrek fonksiyonu ve diyabetes mellitus bileşenlerinden oluşan AHEAD skoru hem sürekli değişken olarak hem de önceden tanımlanmış skor kategorilerine (0, 1, 2 ve ≥3 puan) göre analiz edildi.

Bulgular

Toplam 518 hastanın 143’ünde (%27,6) uzamış YBÜ yatışı saptandı. Uzamış YBÜ yatışı olan hastalarda AHEAD skoru anlamlı olarak daha yüksekti [2 (1-3) vs. 1 (0-2), p<0,001]. Çok değişkenli analizde AHEAD skorundaki her 1 puanlık artış, uzamış YBÜ yatışı ile bağımsız olarak ilişkili bulundu [olasılık oranı (OO): 1,620; %95 güven aralığı (GA): 1,317-1,993; p<0,001]. Uzamış YBÜ yatışı sıklığı AHEAD skor kategorileri boyunca kademeli olarak arttı ve skor ≥3 olan hastalarda %61,2’ye ulaştı. AHEAD skoru 0 olan hastalarla karşılaştırıldığında, skoru 2 ve ≥3 olan hastalarda uzamış YBÜ yatışı olasılığı anlamlı derecede daha yüksekti (sırasıyla OO: 2,060; %95 GA: 1,120-3,788; p=0,020 ve OO: 8,121; %95 GA: 4,089-16,129; p<0,001).

Sonuç

AHEAD skoru, izole KABG sonrası uzamış YBÜ yatışı ile bağımsız olarak ilişkilidir. Rutin olarak elde edilebilen klinik değişkenlere dayanan ve kolaylıkla hesaplanabilen bu skorun klinik rolünün belirlenebilmesi için ileri araştırmalara ihtiyaç vardır.

Anahtar Kelimeler:

Koroner arter bypass greftleme, AHEAD skoru, yoğun bakım ünitesi

Kaynaklar

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