Is hypoalbuminemia a predictor for mortality in Tracheostomized patients transferred from intensive care unit to palliative service?
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Objective: Tracheostomy is a bedside surgical procedure that is frequently performed in intensive care units. It allows patients who need a long-term mechanical ventilator to be transferred from intensive care through a home-type mechanical ventilator. In this study, we aimed to evaluate the relationship between serum albumin levels before hospitalization and discharge or before exitus and mortality in patients who were transferred to the palliative care service with a home type mechanical ventilator by opening a tracheostomy in the intensive care unit.
Material-Method: 110 patients with tracheostomy and home ventilator who were transferred from the intensive care unit to the palliative care service between 01/05/2018-11/05/2021 were analyzed retrospectively. Patients' age, gender, diagnosis of hospitalization (chronic obstructive pulmonary disease (COPD) / malignancy), presence of comorbidity, number of days of tracheostomy (on which day the tracheostomy was opened in the intensive care unit admission), Glasgow Coma Scale (GCS) and intensive care severity scores (Acute Physiology and Chronic Health Evaluation Score (APACHE II), Sequential Organ Failure Assessment (SOFA), hospitalization serum albumin (g/dl) values, and recent serum albumin values of those who had exitus or discharge before discharge or exitus were examined retrospectively.
Results: The study's results showed that the 28-day mortality relation with old age is statistically significant. There is a statistically significant relationship between the high SOFA score at admission to the intensive care unit and 28-day mortality. There is no statistically significant difference between gender, presence of comorbidity in patients with COPD and malignancy hospitalization, GCS, APACHE II showing intensive care severity score, number of days of tracheostomy and 28-day mortality. There is a statistically significant difference between the intensive care hospitalization serum albumin value and the low serum albumin values before discharge/decease and the mortality rate of 28 days.
Conclusion: In the analysis of this study, it was observed that old age and high SOFA score increased 28-day mortality in tracheostomized patients transferred to the palliative service in the intensive care unit. In addition, the low level of albumin values in intensive care hospitalization and before discharge/death also increases mortality.
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