Hemodiyaliz Hastalarında Modifiye CHA2DS2-VASc HSF Skorunun Yaşamı Tehdit Eden Olaylar ve Mortaliteyi Öngörmede Yeri
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Tarih
2025
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Yayıncı
Alanya Alaaddin Keykubat Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Kronik böbrek hastalığı (KBH), dünya genelinde giderek artan yaygınlığı ve yüksek morbidite-mortalite oranları ile önemli bir halk sağlığı sorunudur. Bu hastaların önemli bir bölümü yaşamlarını hemodiyaliz (HD) tedavisi ile sürdürmektedir. HD hastaları, KBH'nın erken evrelerinden itibaren çok sayıda komplikasyon ve ölüm riski ile karşı karşıyadır. Bu nedenle risk faktörlerinin erken dönemde tanımlanması ve etkili bir şekilde yönetilmesi büyük önem taşımaktadır. Modifiye CHA?DS?-VASc HSF skorunun prognoz ve mortalite ile ilişkisini araştıran çeşitli çalışmalar literatürde mevcuttur. Bu tez çalışmasında, hemodiyaliz hastalarında bu skorlama sisteminin miyokard enfarktüsü, kardiyak revaskülarizasyon ihtiyacı, inme gibi yaşamı tehdit eden olaylar ile tüm nedenlere bağlı mortaliteyi öngörme gücünü değerlendirmek amaçlanmıştır. Çok merkezli ve retrospektif tasarıma sahip bu çalışmaya, 2023 yılına ait hastane verileri incelenmiş ve en az 3 aydır HD tedavisi almakta olan, 18 yaş ve üzeri 248 hasta dahil edilmiştir. Hastaların yıl başındaki verilerine göre modifiye CHA?DS?-VASc HSF skorları hesaplanmış; takip eden 12 aylık süreçte gelişen miyokard enfarktüsü, perkütan koroner girişimler, koroner by-pass operasyonları, inme ve mortalite kayıtları analiz edilmiştir. Çalışmaya dahil edilen hastaların %60,1'i erkek olup, yaş ortalaması 62,8±13,1 olarak belirlenmiştir. Ortalama skor 3,64±1,8 olup, %3,2'sinde kardiyak olaylar, %2,8'inde serebrovasküler olaylar, %11,3'ünde ise mortalite gözlenmiştir. CHA?DS?-VASc HSF skorunun ?4,5 olması; hem mortalite (p=0,000) hem de serebrovasküler olay riski (p=0,002) açısından anlamlı bulunmuştur. Sonuç olarak, modifiye CHA?DS?-VASc HSF skoru, hemodiyaliz hastalarında özellikle serebrovasküler olay ve mortalite riskinin öngörülmesinde kullanılabilecek etkili ve pratik bir tarama aracı olarak değerlendirilmektedir. Anahtar Kelimeler: Hemodiyaliz, CHA?DS?-VASc HSF, Prognoz, Mortalite
Chronic kidney disease (CKD) is an increasing global public health concern associated with high morbidity and mortality rates. A substantial proportion of patients with advanced CKD require hemodialysis (HD) therapy to sustain life. From the early stages of CKD, HD patients are exposed to various complications and face a significantly elevated risk of mortality. This underscores the critical importance of timely identification and management of risk factors. The relationship between the modified CHA?DS?-VASc HSF score and clinical outcomes such as prognosis and mortality has been evaluated in several studies. This thesis aims to investigate the utility of the modified CHA?DS?-VASc HSF score in predicting myocardial infarction, need for cardiac revascularization, stroke, and all-cause mortality in patients undergoing chronic HD. This multicenter retrospective study evaluated hospital data from 2023. A total of 248 patients aged 18 years or older who had been receiving HD treatment for at least three months were included. Modified CHA?DS?-VASc HSF scores were calculated using baseline data from the beginning of 2023, and patients were followed for one year to identify occurrences of myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, stroke, and death. Of the patients included, 60.1% were male, with a mean age of 62.8±13.1 years. The mean CHA?DS?-VASc HSF score was 3.64±1.8. During the follow-up period, 3.2% experienced major cardiac events, 2.8% had cerebrovascular events, and 11.3% died. A CHA?DS?-VASc HSF score ?4.5 was found to be statistically significant in predicting both mortality (p=0.000) and stroke (p=0.002). In conclusion, the modified CHA?DS?-VASc HSF score appears to be a practical and effective screening tool for predicting stroke and all-cause mortality in HD patients and may contribute to risk stratification and clinical decision-making in this high-risk population. Keywords: Hemodialysis, CHA?DS?-VASc HSF, Prognosis, Mortality
Chronic kidney disease (CKD) is an increasing global public health concern associated with high morbidity and mortality rates. A substantial proportion of patients with advanced CKD require hemodialysis (HD) therapy to sustain life. From the early stages of CKD, HD patients are exposed to various complications and face a significantly elevated risk of mortality. This underscores the critical importance of timely identification and management of risk factors. The relationship between the modified CHA?DS?-VASc HSF score and clinical outcomes such as prognosis and mortality has been evaluated in several studies. This thesis aims to investigate the utility of the modified CHA?DS?-VASc HSF score in predicting myocardial infarction, need for cardiac revascularization, stroke, and all-cause mortality in patients undergoing chronic HD. This multicenter retrospective study evaluated hospital data from 2023. A total of 248 patients aged 18 years or older who had been receiving HD treatment for at least three months were included. Modified CHA?DS?-VASc HSF scores were calculated using baseline data from the beginning of 2023, and patients were followed for one year to identify occurrences of myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, stroke, and death. Of the patients included, 60.1% were male, with a mean age of 62.8±13.1 years. The mean CHA?DS?-VASc HSF score was 3.64±1.8. During the follow-up period, 3.2% experienced major cardiac events, 2.8% had cerebrovascular events, and 11.3% died. A CHA?DS?-VASc HSF score ?4.5 was found to be statistically significant in predicting both mortality (p=0.000) and stroke (p=0.002). In conclusion, the modified CHA?DS?-VASc HSF score appears to be a practical and effective screening tool for predicting stroke and all-cause mortality in HD patients and may contribute to risk stratification and clinical decision-making in this high-risk population. Keywords: Hemodialysis, CHA?DS?-VASc HSF, Prognosis, Mortality
Açıklama
23.01.2026 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.
Anahtar Kelimeler
İç Hastalıkları, Internal diseases
