Yenidoğan bölümünden çocuk kardiyolojisine konsülte edilen hastaların değerlendirilmesi
Yükleniyor...
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Yenidoğan döneminde kardiyovasküler hastalıkların erken tanı ve tedavisi hayati öneme sahiptir. Bu çalışmada hastaların kardiyak değerlendirmelerinin geriye dönük olarak incelenmesi; konsültasyon endikasyonlarının ve sonucu etkileyebilecek olası parametrelerle birlikte konsültasyon sonuçlarının incelenmesi, saptanan kardiyak hastalıkların sınıflandırılması, benzer çalışmalarla kıyaslanması, eksiklik veya farklılıkların göz önüne serilerek yeni çalışmalara ışık tutması amaçlanmıştır. Bu çalışma, Konya Necmettin Erbakan Üniversitesi Tıp Fakültesi Hastanesi'nde Haziran 2016-Eylül 2021 tarihleri arasında yenidoğan bölümünden çocuk kardiyolojisine konsülte edilen hastaların (n=804) değerlendirildiği retrospektif bir çalışmadır. Veriler sistem kayıtlarından elde edilmiştir. Konsültasyon sonucunda hasta grupları oluşturulurken öncelikli olarak ekokardiyografik değerlendirme göz önüne alınmış, konjenital kalp hastalıkları (KKH) ve normal değerlendirme şeklinde iki bağımsız grup elde edilmiştir. Verilerin istatistiksel analizinde IBM SPSS Statistics 27.0 programı kullanılmış, p<0,05 olduğunda farkın istatistiksel olarak anlamlı olduğu kabul edilmiştir. Çalışmamızda konsültasyon sonucunda hastaların %52,1'i (n=419) KKH olarak değerlendirilmiştir. Ayrıca konsültasyon esnasında hastaların %5,1'inde (n=41) aritmi (15'inde aynı zamanda KKH olduğu) ve %0,2'sinde (n=2) miyokardit tespit edilmiştir. Tüm hastaların %46,3'ünün (n=372) kız, %53,7'sinin (n=432) erkek olduğu; %89,6'sının (n=720) tekil, %10,4'ünün ise (n=84) çoğul gebelikten doğduğu tespit edilmiştir. Erkek bebeklerin 5. dk APGAR değeri ve doğum ağırlığı kız bebeklerden istatistiksel olarak anlamlı yüksek (p<0,05) bulunmuştur. Çoğul gebelikten doğan bebeklerin gebelik yaşı ve doğum ağırlığı tekil gebelikten doğan bebeklerden istatistiksel olarak anlamlı düşük (p<0,05) bulunmuştur. Hastaların %18,9'unun (n=152) normal spontan vajinal yolla, %81,1'inin (n=652) sezaryenle doğduğu tespit edilmiştir. KKH tespit edilen hastaların gebelik haftası, doğum ağırlığı, doğum boyu ve doğum baş çevresi ekokardiyografik değerlendirmesi normal olan hastalardan istatistiksel olarak anlamlı düşük bulunmuştur (p<0,05). Annelerin %19,3'ünde (n=155) endokrinolojik hastalık; bu grupta da en sık diyabet ve tiroid hastalıkları olduğu tespit edilmiştir ve en sık kullanılan ilaç (%7,7) levotiroksindir. Sigara-madde kullanımı olan anne bebeklerinde %75,7 oranında (n=25) kardiyak ve/veya non-kardiyak anomali tespit edilmiştir. Çalışmaya dahil edilen hastaların %26,9'unun (n=216) anne-babası arasında akrabalık olduğu; ailede 30 yaş altında kardiyak hastalık öyküsü olan hastaların %52,6'sında (n=20) KKH tespit edilmiştir. En sık konsültasyon nedeni %22,1 (n=186) oranında üfürümdür. KKH tespit edilen ve normal hastalar arasında konsültasyon esnasındaki nabız ve SpO2 değerleri açısından istatistiksel olarak anlamlı fark bulunmuştur (p<0,05). En sık kardiyak fizik muayene bulgusu %52,8 oranında (n=424) üfürümdür. Ekokardiyografik değerlendirmede en sık ventriküler septal defekt (%24) tespit edilmiştir. Hastaların %4,5'inde (n=36) majör kardiyak bozukluk olup en sık Fallot tetralojisi tespit edilmiştir. Hastaların %23,7'sinde (n=191) ekstrakardiyak anomali olduğu tespit edilmiş olup en sık tanı konan down sendromu (%9,4, n=77) olmuştur. Konsültasyon sonucuna göre hastaların %14,2'sine (n=114) medikal ve/veya cerrahi tedavi önerilmiştir. Çalışma esnasında yapılan taramada hastaların %10,9'unun (n=88) exitus olduğu ve bunların %8'inin (n=7) izole kardiyak nedenli exitus olduğu tespit edilmiştir. Anahtar Kelimeler: yenidoğan, kardiyoloji, konsültasyon, konjenital kalp hastalığı, aritmi, miyokardit
In the neonatal period, early diagnosis and treatment of cardiovascular diseases are of vital importance. This study aims to retrospectively review the cardiac evaluations of patients, examine the indications for consultation and consultation outcomes along with potential influencing parameters, classify identified cardiac diseases, compare them with similar studies, and shed light on new research by highlighting any deficiencies or differences. This study is a retrospective analysis of patients (n=804) referred from the neonatal department to pediatric cardiology at Konya Necmettin Erbakan University Faculty of Medicine Hospital between June 2016 and September 2021. Data were obtained from the hospital records. When creating patient groups based on consultation outcomes, echocardiographic evaluation was given priority, resulting in two independent groups: congenital heart diseases (CHD) and normal evaluations. IBM SPSS Statistics 27.0 was used for the statistical analysis of the data, with a significance level set at p<0.05 to determine statistical significance. In our study, 52.1% (n=419) of patients were classified as having CHD (Congenital Heart Diseases) based on the consultation outcomes. Additionally, during the consultations, arrhythmia was detected in 5.1% (n=41) of patients, with 15 of them also having CHD, and myocarditis was identified in 0.2% (n=2) of patients. Of all the patients, 46.3% (n=372) were female, and 53.7% (n=432) were male. Furthermore, it was determined that 89.6% (n=720) were born from singleton pregnancies, and 10.4% (n=84) were born from multiple pregnancies. Male infants had significantly higher 5-minute APGAR scores and birth weights compared to female infants (p<0.05). Infants born from multiple pregnancies had significantly lower gestational age and birth weight compared to infants from singleton pregnancies (p<0.05). It was determined that 18.9% of the patients (n=152) were born through normal spontaneous vaginal delivery, while 81.1% (n=652) were born via cesarean section. Patients with identified CHD had significantly lower gestational age, birth weight, birth length, and birth head circumference compared to patients with normal echocardiographic evaluations (p<0.05). In 19.3% of the mothers (n=155), endocrine disorders were identified, with diabetes and thyroid diseases being the most common in this group. The most commonly used medication in this group was levothyroxine (7.7%). Among infants of mothers with a history of smoking or substance use, cardiac and/or non-cardiac anomalies were detected in 75.7% of cases (n=25). It was found that 26.9% of the patients included in the study had consanguinity between their parents. In families with a history of cardiac disease in individuals under the age of 30, congenital heart disease was identified in 52.6% of cases (n=20). The most common reason for consultation was a murmur, accounting for 22.1% (n=186) of cases. There was a statistically significant difference in terms of pulse rate and SpO2 values during consultation between patients with identified CHD and those with normal evaluations (p<0.05). The most frequent cardiac physical examination finding was a murmur, observed in 52.8% of cases (n=424). Among the echocardiographic evaluations, ventricular septal defect was the most common (24%). Major cardiac anomalies were present in 4.5% of patients (n=36), with Fallot's tetralogy being the most frequently identified. Additionally, 23.7% of patients (n=191) had extracardiac anomalies, with Down syndrome being the most frequently diagnosed (9.4%, n=77). According to the consultation outcomes, 14.2% of patients (n=114) were recommended for medical and/or surgical treatment. During the study, a screening revealed that 10.9% of patients (n=88) had passed away, with 8% (n=7) of them having isolated cardiac causes for their demise. Keywords: neonate, cardiology, consultation, congenital heart disease, arrhythmia, myocarditis
In the neonatal period, early diagnosis and treatment of cardiovascular diseases are of vital importance. This study aims to retrospectively review the cardiac evaluations of patients, examine the indications for consultation and consultation outcomes along with potential influencing parameters, classify identified cardiac diseases, compare them with similar studies, and shed light on new research by highlighting any deficiencies or differences. This study is a retrospective analysis of patients (n=804) referred from the neonatal department to pediatric cardiology at Konya Necmettin Erbakan University Faculty of Medicine Hospital between June 2016 and September 2021. Data were obtained from the hospital records. When creating patient groups based on consultation outcomes, echocardiographic evaluation was given priority, resulting in two independent groups: congenital heart diseases (CHD) and normal evaluations. IBM SPSS Statistics 27.0 was used for the statistical analysis of the data, with a significance level set at p<0.05 to determine statistical significance. In our study, 52.1% (n=419) of patients were classified as having CHD (Congenital Heart Diseases) based on the consultation outcomes. Additionally, during the consultations, arrhythmia was detected in 5.1% (n=41) of patients, with 15 of them also having CHD, and myocarditis was identified in 0.2% (n=2) of patients. Of all the patients, 46.3% (n=372) were female, and 53.7% (n=432) were male. Furthermore, it was determined that 89.6% (n=720) were born from singleton pregnancies, and 10.4% (n=84) were born from multiple pregnancies. Male infants had significantly higher 5-minute APGAR scores and birth weights compared to female infants (p<0.05). Infants born from multiple pregnancies had significantly lower gestational age and birth weight compared to infants from singleton pregnancies (p<0.05). It was determined that 18.9% of the patients (n=152) were born through normal spontaneous vaginal delivery, while 81.1% (n=652) were born via cesarean section. Patients with identified CHD had significantly lower gestational age, birth weight, birth length, and birth head circumference compared to patients with normal echocardiographic evaluations (p<0.05). In 19.3% of the mothers (n=155), endocrine disorders were identified, with diabetes and thyroid diseases being the most common in this group. The most commonly used medication in this group was levothyroxine (7.7%). Among infants of mothers with a history of smoking or substance use, cardiac and/or non-cardiac anomalies were detected in 75.7% of cases (n=25). It was found that 26.9% of the patients included in the study had consanguinity between their parents. In families with a history of cardiac disease in individuals under the age of 30, congenital heart disease was identified in 52.6% of cases (n=20). The most common reason for consultation was a murmur, accounting for 22.1% (n=186) of cases. There was a statistically significant difference in terms of pulse rate and SpO2 values during consultation between patients with identified CHD and those with normal evaluations (p<0.05). The most frequent cardiac physical examination finding was a murmur, observed in 52.8% of cases (n=424). Among the echocardiographic evaluations, ventricular septal defect was the most common (24%). Major cardiac anomalies were present in 4.5% of patients (n=36), with Fallot's tetralogy being the most frequently identified. Additionally, 23.7% of patients (n=191) had extracardiac anomalies, with Down syndrome being the most frequently diagnosed (9.4%, n=77). According to the consultation outcomes, 14.2% of patients (n=114) were recommended for medical and/or surgical treatment. During the study, a screening revealed that 10.9% of patients (n=88) had passed away, with 8% (n=7) of them having isolated cardiac causes for their demise. Keywords: neonate, cardiology, consultation, congenital heart disease, arrhythmia, myocarditis
Açıklama
Anahtar Kelimeler
Yenidoğan, Kardiyoloji, Konsültasyon, Konjenital kalp hastalığı, Aritmi, Miyokardit, Neonate, Cardiology, Consultation, Congenital heart disease, Arrhythmia, Myocarditis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Akgül, A. H. (2023). Yenidoğan bölümünden çocuk kardiyolojisine konsülte edilen hastaların değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
