دوره 32، شماره 275: هفته چهارم فروردین ماه 1393:149-159

استفاده از روش 60-CURB و 60-CRB در تعیین پیش‌آگهی پنومونی اکتسابی از جامعه‌ی سالمندان

علی اصغر فرازی, معصومه صوفیان, بنفشه نایب‌زاده

چکیده


مقدمه: با توجه به افزایش میزان مرگ و میر ناشی از پنومونی در افراد سالمند، استفاده از مدل ساده‌تر برای تعیین پیش‌آگهی پنومونی می‌تواند به كاهش میزان مرگ و میر در این گروه سنی بیانجامد. هدف این مطالعه، تعیین اعتبار مدل 60-CURB (years 60 ≤ Confusion, uremia, respiratory rate, blood pressure, and age) و مدل 60-CRB (years 60 ≤ Confusion, respiratory rate, blood pressure, and age) و مقایسه‌ی آن با مدل‌های PSI (Pneumonia severity index) و 65-CURB و 65-CRB بود.

روش‌ها: این مطالعه یک مطالعه‌ی توصیفی- مقطعی بود که در سال 1392 در دانشگاه علوم پزشکی اراک به انجام رسید. اطلاعات 141 بیمار 60 سال و بالاتر مبتلا به پنومونی اکتسابی از جامعه که دارای شرایط ورود به مطالعه بودند، به وسیله‌ی نرم‌افزار SPSS نسخه‌ی 18
 مورد تجزیه و تحلیل قرار گرفت. 050/0 ≥ P معنی‌دار تلقی شد.

یافته‌ها: میانگین سنی بیماران در این مطالعه، 6/7 ± 9/68 و میانه 65 سال بود. 76 بیمار (9/53 درصد) مذکر و نسبت جنسی مرد به زن 17/1 بود. 6/71 درصد بیماران ساکن شهر بودند. شایع‌ترین بیماری‌های همراه بیماری‌های قلبی- عروقی (6/37 درصد) بود. شایع‌ترین علامت رال و رونکای (2/92 درصد) و هپپوترمی یا هیپرترمی (7/88 درصد) بود. از نظر بهبودی روز سوم حساسیت، ویژگی و ارزش اخباری مثبت مدل PSI (Pneumonia severity index) و 60-CURB بیشتر از سایر مدل‌ها بود و از نظر بستری در ICU (Intensive care unit) تا روز چهاردهم و مرگ تا روز سی‌ام بیشترین ارزش اخباری مثبت مربوط به مدل 65-CURB و 60-CRB بود.

نتیجه‌گیری: برای تعیین شدت و پیش‌آگهی پنومونی اکتسابی از جامعه در سالمندان، می‌توان از مدل 60-CURB و مدل 60-CRB استفاده نمود.


واژگان کلیدی


پنومونی اکتسابی از جامعه؛ 60-CURB؛ 60-CRB؛ سالمندان

تمام متن:

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مراجع


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