Acil Serviste 65 Yaş Üzerindeki Olguların Mental Durum Değerlendirmesinde “Kısa Kognitif Muayene” Ve “Kısa Bilişsel Durum” Testlerinin Karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2001
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
Yaşlı hastalarda sık görülen kognitif bozuklukların erken saptanması ve tedavi edilebilmesi için acil serviste kısa, kolay uygulanabilen, standart bir testin kullanılması önem kazanmaktadır. Bu araştırmada Mini Mental State Examination (MMSE) testinin ülkemiz için adapte edilmiş şekli olan Kısa Kognitif Muayene (KKM, Standardize Mini Mental Test) ile Kısa Bilişsel Durum Testlerinin (KBD, Brief Mental Status Examination) testlerinden alınan skorların karşılaştırılması amaçlanmıştır. Gereçler ve Yöntem: Bu prospektif çalışmada 65 yaş üzerindeki ardışık 300 hastaya KBD ve KKM testleri uygulanmıştır. 2 ay sonra 300 hastadan ulaşılabilen 110 hastaya aynı testler tekrar uygulanmıştır. Sonuçlar hekimin test öncesi klinik yargısıyla karşılaştırılmış ve demografik faktörler ve testlerin uyumu yönünden incelenmiştir.
Bulgular: Çalışmada KBD ve KKM test skoru ortalamalarının yaş ilerledikçe kötüye gittiği saptanmıştır. Erkeklerin test skorlarının kadınlara göre (KKM p<0.001, KBD p=0.003), evli olanların test skorlarının dul olanlara göre daha iyi olduğu (KKM p=0.001, KBD p=0.001) saptanmıştır. Emeklilerin test skorları diğerlerinden daha iyi olduğu ve (KKM p<0.001, KBD p=0.003) ilkokul mezunlarının skorlarının en düşük olduğu bulunmuştur (KKM p<0.001, KBD p=0.001). KKM ve KBD testlerinin orta derecede uyumlu olmasıyla acil serviste mental durum bakısında kullanılabileceği sonucuna varılmıştır (kappa 0.40, p<0.001). KKM’ye göre KBD’nin sensitivitesi %79, spesifisitesi %60 olarak bulunmuştur.
Sonuç: Çalışma sonucunda KKM ve KBD testlerinin acil serviste hızlı, kolay uygulanabilir testler olduğu görülmüştür. Daha geniş, çok merkezli çalışmalarla desteklendiğinde acil servise başvuran hastaların mental durum muayenesinde alternatif bir yöntem olarak kullanılabilir.
Standardized tests applied briefly and easily are beneficial in order to identify and treat cognitive disorders of elderly. This study aims to compare scores of elderly patients from Standardized Mini Mental Test (SMMT) with scores from Brief Mental Status Examination (BMSE). Methods: This prospective study enrolled 300 consecutive emergency department (ED) patients over 65 years of age. All patients were given a rough assessment of mental status and underwent SMMT and BMSE tests. Test scores were compared with the pre-test clinical judgement of the physician. After two months tests were repeated for 110 of the patients who could be found and the difference in scores were calculated. Results: Men’s scores were higher than women’s (SMMT p<0.001, BMSE p=0.003) and married patients scored higher than widows (SMMT p=0.001, BMSE p=0.001). The scores were also inversely associated with age and retired patients obtained higher scores than the others (SMMT p<0.001, BMSE p=0.003). Level of education was found relevant as primary school graduates had the lowest scores (SMMT p<0.001, BMSE p=0.001). SMMT scores were moderately correlated with BMSE scores which showed the tests could be used for mental status examination in the ED (kappa 0.40, p<0.001). BMSE was found %79 sensitive and %60 specific taking SMMT as the standard method. Conclusion: SMMT scores were not proved to be useful in predicting short term prognosis. The tests were shown to be applied rapidly and easily in the ED population. If supported by broader studies, these tests can be used as applicable methods in mental status examination of elderly patients.
Standardized tests applied briefly and easily are beneficial in order to identify and treat cognitive disorders of elderly. This study aims to compare scores of elderly patients from Standardized Mini Mental Test (SMMT) with scores from Brief Mental Status Examination (BMSE). Methods: This prospective study enrolled 300 consecutive emergency department (ED) patients over 65 years of age. All patients were given a rough assessment of mental status and underwent SMMT and BMSE tests. Test scores were compared with the pre-test clinical judgement of the physician. After two months tests were repeated for 110 of the patients who could be found and the difference in scores were calculated. Results: Men’s scores were higher than women’s (SMMT p<0.001, BMSE p=0.003) and married patients scored higher than widows (SMMT p=0.001, BMSE p=0.001). The scores were also inversely associated with age and retired patients obtained higher scores than the others (SMMT p<0.001, BMSE p=0.003). Level of education was found relevant as primary school graduates had the lowest scores (SMMT p<0.001, BMSE p=0.001). SMMT scores were moderately correlated with BMSE scores which showed the tests could be used for mental status examination in the ED (kappa 0.40, p<0.001). BMSE was found %79 sensitive and %60 specific taking SMMT as the standard method. Conclusion: SMMT scores were not proved to be useful in predicting short term prognosis. The tests were shown to be applied rapidly and easily in the ED population. If supported by broader studies, these tests can be used as applicable methods in mental status examination of elderly patients.
Açıklama
Anahtar Kelimeler
Yaşlı, Acil Servis, Mental Durum Değerlendirmesi, Elderly, Emergency Department, Mental Status Evaluation
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Karcıoğlu, Özgür ;Keleş, Ayfer ;Soysal, Suna ;Coşkun, Figen ;Aslan, Belgin Ü. ;İnönü Üniversitesi Tıp Fakültesi Dergisi.
