Acil serviste üriner taş tanısı alan hastaların klinik ve laboratuvar sonuçlarının değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada Acil serviste üriner sistem taşı saptanan ve Üroloji polikliniği tarafından takipleri devam eden hastalarda idrar kültürü pozitifliği oranı ve idrar kültürü pozitifliği oranını etkileyen faktörler inceledik. Bu hastaların idrar kültürü sonuçları çıkana kadar yapılan tetkik ve tedavileri üroloji polikliniğindeki sonuçlarıyla değerlendirdik. Çalışmamızın üriner taşı olan hastaların değerlendirilmesinde acil servis çalışanlarına faydalı bilgiler sağlayacağını düşünmekteyiz. Materyal ve Metot: Bu çalışmada İnönü Üniversitesi Tıp Fakültesi Turgut Özal Tıp Merkezi Acil Tıp Anabilim Dalı'na 1 Ocak 2016 ile 1 Kasım 2022 tarihleri arasında başvuran, görüntüleme ile üriner taş saptanan ve Üroloji polikliniğinde takipleri devam eden hastalar geriye dönük olarak incelenmiştir. Hastaların yaş ve cinsiyeti, laboratuvar tetkiki olarak hemogram, tam idrar tetkiki, seroloji ve idrar kültürü sonuçları incelenmiştir. Çalışmamızdan elde ettiğimiz tüm parametreler ile çoklu lojistik regresyon analizi yapıldı ve analiz Hosmer&Lemeshow testine göre istatistiksel olarak anlamlıydı. Bulgular: Çalışmamızda 99'u (%28,37) kadın ve 250'si erkek (%71,63) olmak üzere toplam 349 hasta vardı ve hastaların 40'ında (%11.7) idrar kültüründe bir patojen mikroorganizma üremesi gözlemlendi. İdrar kültüründe en sık rastlanan ilk iki mikroorganizma Escherichia Coli (24/40) ve Klebsiella spp. (5/40) idi. Lojistik regresyon modelinde nitrit pozitifliği %48.8, idrar WBC artışı %0.2, idrarda bakteri varlığı %3.06, hasta yaşının artışı %2.6 oranlarında kültür pozitifliği olasılığını arttırmaktaydı. HGB değerindeki her 1 birimlik artış ise idrar kültürünün pozitif çıkma olasılığını %27.8 düşürmekteydi. Sonuç: Üriner sistem taşı olan hastalarda tam idrar tetkikinde lökosit sayısı, bakteri varlığı, nitrit pozitifliği, kan hemoglobin düşüklüğü ve hastanın ileri yaşta olması idrar kültürünün pozitif olma olasılığını arttırır. Üriner sistem taşı olan hastalar değerlendirilirken idrar kültürü alınması kararında veya idrar kültürü sonuçlanana kadar geçen süredeki tedavi yönetiminde bu parametrelerin göz önünde bulundurulması gerekir.
Aim: In this study, we examined the factors affecting the rate of urine culture positivity and the rate of urine culture positivity in patients who were found to have kidney stones in the emergency department and were followed up by the Urology outpatient clinic. We evaluated the examinations and treatments of these patients with the results of the urology outpatient clinic until the urine culture results were obtained. We think that our study will provide useful information to emergency service workers in the evaluation of patients with urinary system stones. Material and method: In this study, patients who applied to Emergency Medicine Department of İnönü University Faculty of Medicine between January 1st, 2016 and November 1st, 2022, who were diagnosed with urinary calculi by imaging and who were followed up in the Urology outpatient clinic, were retrospectively analyzed. The age and gender of the patients, as laboratory tests, complete blood count, urinalysis, serology and urine culture results were examined. Multiple logistic regression analysis was performed with all the parameters obtained from our study and the analysis was statistically significant according to the Hosmer&Lemeshow test. Results: In our study, there were a total of 349 patients, 99 (28.37%) female and 250 (71.63%) male, and a pathogenic microorganism growth was observed in the urine culture of 40 (11.7%) of the patients. The first two microorganisms most frequently encountered in urine culture were Escherichia Coli (24/40) and Klebsiella spp. (5/40). In the logistic regression model, nitrite positivity increased 48.8%, urinary white blood cells increased 0.2%, bacteria presence in urine 3.06%, and increased patient age increased the probability of culture positivity by 2.6%. Each 1 unit increase in hemoglobin value decreased the probability of positive urine culture by 27.8%. Conclusion: The leukocyte count, bacteria presence, nitrite positivity, low blood hemoglobin and advancing advanced age in the complete expulsion examination of a patient with urinary system stone are the prediction of a positive ejection result. These data should be considered in the decision to take the culture of dissemination at the time of death of patients with urinary tract stones or the management of care during the time until they reach the respiratory tract.
Aim: In this study, we examined the factors affecting the rate of urine culture positivity and the rate of urine culture positivity in patients who were found to have kidney stones in the emergency department and were followed up by the Urology outpatient clinic. We evaluated the examinations and treatments of these patients with the results of the urology outpatient clinic until the urine culture results were obtained. We think that our study will provide useful information to emergency service workers in the evaluation of patients with urinary system stones. Material and method: In this study, patients who applied to Emergency Medicine Department of İnönü University Faculty of Medicine between January 1st, 2016 and November 1st, 2022, who were diagnosed with urinary calculi by imaging and who were followed up in the Urology outpatient clinic, were retrospectively analyzed. The age and gender of the patients, as laboratory tests, complete blood count, urinalysis, serology and urine culture results were examined. Multiple logistic regression analysis was performed with all the parameters obtained from our study and the analysis was statistically significant according to the Hosmer&Lemeshow test. Results: In our study, there were a total of 349 patients, 99 (28.37%) female and 250 (71.63%) male, and a pathogenic microorganism growth was observed in the urine culture of 40 (11.7%) of the patients. The first two microorganisms most frequently encountered in urine culture were Escherichia Coli (24/40) and Klebsiella spp. (5/40). In the logistic regression model, nitrite positivity increased 48.8%, urinary white blood cells increased 0.2%, bacteria presence in urine 3.06%, and increased patient age increased the probability of culture positivity by 2.6%. Each 1 unit increase in hemoglobin value decreased the probability of positive urine culture by 27.8%. Conclusion: The leukocyte count, bacteria presence, nitrite positivity, low blood hemoglobin and advancing advanced age in the complete expulsion examination of a patient with urinary system stone are the prediction of a positive ejection result. These data should be considered in the decision to take the culture of dissemination at the time of death of patients with urinary tract stones or the management of care during the time until they reach the respiratory tract.
Açıklama
Anahtar Kelimeler
Acil Tıp, Emergency Medicine
