Geriatrik ve nongeriatrik kronik karaciğer parankim hastalarında beslenme parametreleri ile MNA ve sGA'nın karşılaştırılması
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kronik karaciğer hastalığı ülkemiz gibi hepatit viruslarının sık görüldüğü toplumlarda önemli bir halk sağlığı problemi haline gelmektedir. Kronik karaciğer hastalarında birçok problemle birlikte beslenme sorunu da önemli bir mortalite ve morbidite nedenidir. Yaşın ilerlemesiyle beraber, özellikle 65 yaş üstü geriatrik populasyonda malnütrisyon daha da önemli hale gelmektedir. Biz bu çalışmada 65 yaş üstü 37, 65 yaş altı 30 tane çeşitli etyolojilerle meydana gelmiş olan kronik karaciğer parankim hastasını ele aldık. Hastalarda Mini Nütrisyonel Değerlendirme(MNA) ve Subjektif Global Değerlendirme(SGA) testleri yapıldı. Anket değerlendirmesi ile laboratuvar parametreleri güncel olarak kıyaslandı. Materyal metod: Çalışmamızda İnönü Üniversitesi Turgut Özal Tıp Merkezi Hepatoloji Polikliniğine, Gastroenteroloji Yoğun Bakıma, Organ Nakli Servisine, Organ Nakli Yoğun Bakımına başvuran 113 kronik karaciğer parankim hastasından transplantasyon yapılmamış, ek hastalığı olmayan, aktif enfeksiyonu olmayan 67 hasta incelendi. Hastalarla yüz yüze görüşülerek MNA, SGA testleri yapıldı, skorlar hesaplandı. Hastaların güncel laboratuvar değerlerinden; total protein, albumin, hemoglobin, trombosit, WBC, INR, glukoz, BUN, kreatinin, bilirubin, sodyum, potasyum, kalsiyum değerlerine bakıldı. Ultrasonografi ile asit değerlendirilmesi yapıldı. Hastaların ensefalopati derecesine bakıldı. CHILD ve MELD skorları hesaplandı. Sonuç: Araştırmamızın neticesinde 65 yaş üstü ve altı hasta gruplarının albümin, total protein, CHILD ve MELD skorları, kalsiyum, glukoz, INR, sodyum, potasyum, hemoglobin trombosit, asit, ensefalopati dereceleri arasında anlamlı farklılık izlenmedi. Her iki hasta grubunun MNA skorları ile SGA skorları karşılaştırıldı. Her iki kronik karaciğer parankim hastalığı ile takipli hasta grubunun MNA ve SGA skorları arasında anlamlı bir fark izlenmedi. MNA skoruna göre hastalar normal, malnütrisyon riski altındakiler ve malnütrisyonlu olarak değerlendirildiğinde hastaların albumin değerleri arasında anlamlı farklılık saptandı SGA skoruna göre de her iki yaş grubu arasında anlamlı farklılık saptanmadı. Hastalar SGA skorlarına göre iyi beslenmiş, orta derecede malnütrisyon, ciddi malnütrisyon grubu olarak sınıflandırıldıklarında grupların albümin değerleri arasında anlamlı farklılık saptandı. Her iki hasta grubunda da düşük MNA skoru olanların CHILD puanının yüksek olduğu görüldü. Geriatrik ve geriatrik olmayan kronik karaciğer hastalarında her iki değerlendirme testinin de hastalarda malnütrisyonu tespit etmede kullanılabileceği görüldü.
Chronic liver disease has become an important public health problem in societies in which hepatitis viruses are common, in our country as well. Along with many problems in chronic liver disease, nutritional problems are also an important cause of mortality and morbidity. With age, malnutrition becomes even more important, especially in the geriatric population over 65 years of age. In this study, we examined the chronic liver parenchyma patients who had come to the scene with various etiologic agents that 37 persons over the age of 65 years and 30 year old ones below 65 years. Mini-Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) tests were performed in the patients. The questionnaire evaluation and laboratory parameters were compared timely. Materials and Methods: We studied 67 patients who were not transplanted from 113 patients with chronic liver parenchyma who were referred to İnönü University Turgut Özal Medical Center Hepatology Policlinic, Gastroenterology Intensive Care, Organ Transplantation, Organ Transplantation Intensive Care, without any additional diseases and no active infections. MNA, SGA tests were performed with face-to-face interviews with the patients and scores were calculated. Total protein, albumin, hemog-lobin, thrombocyte, WBC, INR, glucose, BUN, creatinine, bilirubin, sodium, potassium and calcium were measured from patients' current laboratory values. Acid evaluation was performed through ultrasonography. The degree of encephalopathy of the patients was checked. The CHILD and MELD scores are calculated. Conclusion: There were no significant differences in albumin, total protein, CHILD and MELD scores, calcium, glucose, INR, sodium, potassium, hemoglobin, platelets, acid and encephalopathy scores in over 65 and below age groups. MNA scores and SGA scores of both patient groups were compared. There was no significant difference between MNA and SGA scores of patients with both chronic liver parenchymal disease group and the follow-up one. According to the MNA score, there was a significant difference in the albumin values of the patients when the patients were evaluated as at normal risk, at the risk of malnutrition and at malnutrition. According to SGA score, no significant difference was found between the two age groups. A significant difference was found between the albumin values of the groups when the patients were classified as malnutrition, severe malnutrition and malnutrition as well as nourished according to SGA scores. It was seen that the score of CHILD was higher in patients with low MNA scores in both groups. In both geriatric and non-geriatric chronic liver diseases, it was observed that both assessment tests could be used to detect malnutrition in patients.
Chronic liver disease has become an important public health problem in societies in which hepatitis viruses are common, in our country as well. Along with many problems in chronic liver disease, nutritional problems are also an important cause of mortality and morbidity. With age, malnutrition becomes even more important, especially in the geriatric population over 65 years of age. In this study, we examined the chronic liver parenchyma patients who had come to the scene with various etiologic agents that 37 persons over the age of 65 years and 30 year old ones below 65 years. Mini-Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) tests were performed in the patients. The questionnaire evaluation and laboratory parameters were compared timely. Materials and Methods: We studied 67 patients who were not transplanted from 113 patients with chronic liver parenchyma who were referred to İnönü University Turgut Özal Medical Center Hepatology Policlinic, Gastroenterology Intensive Care, Organ Transplantation, Organ Transplantation Intensive Care, without any additional diseases and no active infections. MNA, SGA tests were performed with face-to-face interviews with the patients and scores were calculated. Total protein, albumin, hemog-lobin, thrombocyte, WBC, INR, glucose, BUN, creatinine, bilirubin, sodium, potassium and calcium were measured from patients' current laboratory values. Acid evaluation was performed through ultrasonography. The degree of encephalopathy of the patients was checked. The CHILD and MELD scores are calculated. Conclusion: There were no significant differences in albumin, total protein, CHILD and MELD scores, calcium, glucose, INR, sodium, potassium, hemoglobin, platelets, acid and encephalopathy scores in over 65 and below age groups. MNA scores and SGA scores of both patient groups were compared. There was no significant difference between MNA and SGA scores of patients with both chronic liver parenchymal disease group and the follow-up one. According to the MNA score, there was a significant difference in the albumin values of the patients when the patients were evaluated as at normal risk, at the risk of malnutrition and at malnutrition. According to SGA score, no significant difference was found between the two age groups. A significant difference was found between the albumin values of the groups when the patients were classified as malnutrition, severe malnutrition and malnutrition as well as nourished according to SGA scores. It was seen that the score of CHILD was higher in patients with low MNA scores in both groups. In both geriatric and non-geriatric chronic liver diseases, it was observed that both assessment tests could be used to detect malnutrition in patients.
Açıklama
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology
