Infekcijas un to biežums pacientiem ar akūtu insultu.
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Date
2022
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Journal ISSN
Volume Title
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Infekcijas un to biežums pacientiem ar akūtu insultu. Elīna Selivončika, darba vadītājs Rīgas Stradiņa universitātes infektoloģijas katedras docētājs, Dr.med., Prof. Guntis Karelis.
Darba mērķis ir izpētīt infekcijas un to biežumu pacientiem ar akūtu insultu.
Darba uzdevumi:
1. Izpētīt literatūras datus par infekciju biežumu pacientiem ar akūtu insultu, iespējamajiem riska faktoriem un blakusslimībām, kas var veicināt to attīstību.
2. Apkopot pacientu stacionāro karšu datus par infekcijām, to biežumu, topogrāfiju, blakusslimībām, riska faktoriem.
3. Veikt iegūto datu analīzi: nosakot infekciju biežumu, identificējot biežākos ierosinātājus un infekciju lokalizāciju, pielietoto antibakteriālo terapiju, identificējot blakusslimības un riska faktorus, kuri veicina infekciju attīstību.
4. Salīdzināt iegūtos datus ar citos pētījumos iegūtajiem datiem
Darbā tika analizēts: dzimums, vecums, NIHSS iestājoties, mRS iestājoties, insulta veids, nikotīnisms, alkohola lietošana, cukura diabēts, hroniskas plaušu slimības, hroniska nieru slimība, arteriālā hipertensija, koronārā sirds slimība, audzējs, ātriju fibrillācija, neirodeģeneratīva saslimšana, ateroskleroze, insults anamnēzē, trombolīze, trombektomija, nazogastrālā zonde, disfāgija, vemšana, intubācija, urīnpūšļa katetrs, intravenozā kanile, imobilitāte, izgulējumi, infekcija, infekcijas topogrāfija, ierosinātājs, antibakteriāli līdzekļi, iznākums, infekcijas diagnosticēšanas laiks, gultas dienu skaits stacionārā.
Pētījumā secināts, ka infekcijas slimību prevalence pacientiem ar akūtu insultu ir 23,3%. Pacientiem ar akūtu insultu biežākie infekcijas ierosinātāji ir Esherichia coli, Staphylococcus hominis, Staphylococcus aureus, Enterococcus faecalis, SARS CoV-2. Biežākā infekciju lokalizācija ir UCI, pneimonija un sepse. Ir identificēti vairāki ar pacientu saistīti riska faktori infekciju attīstībai: nikotīnisms, hroniska nieru slimība, koronārā sirds slimība, ātriju fibrillācija, neirodeģeneratīvas slimības. Riska faktori infekciju attīstībai pacientiem ar akūtu insultu ir nazogastrālā zonde, disfāgija, intubācija, urīnpūšļa katetrs, izgulējumi. NIHSS un mRS var tikt izmantoti kā prognostiskais faktors infekcijas attīstībai. Alkohola lietošana, insulta veids, cukura diabēts, plaušu slimības, arteriālā hipertensija, ateroskleroze, audzējs, insults anamnēzē, trombolīze, trombektomija nesaistās ar paaugstinātu infekcijas attīstīšanās risku. Attīstoties infekcijai pacietiem ar akūtu insultu, pagarinās uzturēšanas ilgums slimnīcā. Insulta pacientu mirstību īstermiņā nepalielina infekcijas attīstība.
Darbs satur 30 lapas, 2 attēlus, 1 tabulu, 50 literatūras avotus, 2 pielikumus. Darbā analizētas pacientu slimības vēstures Rīgas Austrumu klīniskajā universitātes slimnīcā, stacionārā “Gaiļezers”. Pētījumā tika iekļautas 605 pacientu slimības vēstures. Darba rezultāti apkopoti, analizēti un attēloti 1 tabulā un 2 attēlos.
Infections in patients with acute stroke. Elīna Selivončika, supervisor Lecturer, Department of Infectious Diseases, Riga Stradins University, MD., Prof. Guntis Karelis. The aim of the study was to investigate infections and their frequency in patients with acute stroke. Tasks: 1. To study the available literature, containing the information about the incidence of infections in patients with acute stroke, possible risk factors and comorbidities that may contribute to their development. 2. To collect the data from patient’s medical records about infections, their frequency, topography, comorbidities, risk factors. 3. To analyze the obtained data: to determine how many patients with acute stroke have an infection, identify the most common infectious agents and the topography of the infections, to determine the used antibacterial agents, to identify co-morbidities associated with the development of infection. 4. To compare the obtained data with the data from other studies. The data that was analyzed in the study: gender, age, NIHSS onset, mRS onset, nicotinism, stroke type, diabetes, chronic kidney disease, arterial hypertension, coronary heart disease, tumor, atrial fibrillation, neurodegenerative disease, atherosclerosis history, thrombolysis, thrombectomy, nasogastric tube, dysphagia, vomiting, intubation, bladder catheter, intravenous cannula, immobility, bedsores, infection, topography of the infection, causative agent, antibacterial agents, outcome, time to diagnosis of infection, bedtime The study concluded that the prevalence of infectious diseases in patients with acute stroke is 23.3%. The most common pathogens in patients with acute stroke are Esherichia coli, Staphylococcus hominis, Staphylococcus aureus, Enterococcus faecalis, SARS CoV-2. The most common localizations of infections are UTI, pneumonia and sepsis. Several patient-related risk factors for the development of infections have been identified: nicotinism, chronic kidney disease, coronary heart disease, atrial fibrillation, neurodegenerative diseases. Risk factors for the development of infections in patients with acute stroke include nasogastric tube, dysphagia, intubation, bladder catheter, bedsores. Alcohol use, type of stroke, diabetes mellitus, pulmonary disease, arterial hypertension, atherosclerosis, tumor, history of stroke, thrombolysis, thrombectomy are not associated with an increased risk of infection. NIHSS and mRS can be used as prognostic factors for the development of infection. As the infection develops in patients with an acute stroke, the length of a hospital stay increases. The development of infection in the short term does not increase the mortality of stroke patients. The work contains 30 pages, 2 figures, 1 table, 50 references, 2 appendices. In the study were used patient medical records available in the archive of the clinical center "Gaiļezers" of the Riga East Clinical University Hospital. The study included the medical records of 605 patients.
Infections in patients with acute stroke. Elīna Selivončika, supervisor Lecturer, Department of Infectious Diseases, Riga Stradins University, MD., Prof. Guntis Karelis. The aim of the study was to investigate infections and their frequency in patients with acute stroke. Tasks: 1. To study the available literature, containing the information about the incidence of infections in patients with acute stroke, possible risk factors and comorbidities that may contribute to their development. 2. To collect the data from patient’s medical records about infections, their frequency, topography, comorbidities, risk factors. 3. To analyze the obtained data: to determine how many patients with acute stroke have an infection, identify the most common infectious agents and the topography of the infections, to determine the used antibacterial agents, to identify co-morbidities associated with the development of infection. 4. To compare the obtained data with the data from other studies. The data that was analyzed in the study: gender, age, NIHSS onset, mRS onset, nicotinism, stroke type, diabetes, chronic kidney disease, arterial hypertension, coronary heart disease, tumor, atrial fibrillation, neurodegenerative disease, atherosclerosis history, thrombolysis, thrombectomy, nasogastric tube, dysphagia, vomiting, intubation, bladder catheter, intravenous cannula, immobility, bedsores, infection, topography of the infection, causative agent, antibacterial agents, outcome, time to diagnosis of infection, bedtime The study concluded that the prevalence of infectious diseases in patients with acute stroke is 23.3%. The most common pathogens in patients with acute stroke are Esherichia coli, Staphylococcus hominis, Staphylococcus aureus, Enterococcus faecalis, SARS CoV-2. The most common localizations of infections are UTI, pneumonia and sepsis. Several patient-related risk factors for the development of infections have been identified: nicotinism, chronic kidney disease, coronary heart disease, atrial fibrillation, neurodegenerative diseases. Risk factors for the development of infections in patients with acute stroke include nasogastric tube, dysphagia, intubation, bladder catheter, bedsores. Alcohol use, type of stroke, diabetes mellitus, pulmonary disease, arterial hypertension, atherosclerosis, tumor, history of stroke, thrombolysis, thrombectomy are not associated with an increased risk of infection. NIHSS and mRS can be used as prognostic factors for the development of infection. As the infection develops in patients with an acute stroke, the length of a hospital stay increases. The development of infection in the short term does not increase the mortality of stroke patients. The work contains 30 pages, 2 figures, 1 table, 50 references, 2 appendices. In the study were used patient medical records available in the archive of the clinical center "Gaiļezers" of the Riga East Clinical University Hospital. The study included the medical records of 605 patients.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Insults, infekcijas, pēcinsulta infekcija, NIHSS, Stroke, infections, post-stroke infection, NIHSS