ÖZET
Amaç:
Taburcu edilen hastaların yaklaşık %10’ u yatış süresi içerisinde yeniden yoğun bakım ünitesine (YBÜ) gitmektedir. YBÜ’ye yeniden yatış oranlarındaki azalma, hastane performansında bir kalite göstergesidir. Bu çalışmadaki amacımız, YBÜ’den hastane içine, iki yıllık süre içerisinde taburcu edilen hastaların yeniden yatışlarının nedenlerini ve sonuçlarını analiz etmektir.
Yöntem:
01.01.2015-31.12.2016 tarihleri arasında hastanemiz YBÜ’de tedavi edilen hastaların tekrar yatışları geriye dönük olarak incelendi. Hastaların demografik özellikleri, tekrar yatış oranları, hastaların ilk yatış endikasyonları ve yandaş hastalıkları, tekrar yatışların endikasyonlarına göre dağılımı, tekrar yatışın taburculuk sonrası ne zaman gerçekleştiği, mekanik ventilasyon ihtiyacına göre hastaların dağılımı, tekrar yatışı olan hastaların birinci kabullerinde weaning sonrası taburcu olma zamanı, tekrar yatışlardaki mortalite oranları, hastaların YBÜ’ye ilk ve tekrar yatışındaki Glasgow Koma Skalası (GCS), APACHE-II ve SOFA skorları incelenerek kıyaslandı.
Bulgular:
YBÜ’den taburcu edilen ve hastaneden taburcu olmadan tekrar yatışı yapılan hasta sayısı 59 olarak bulundu (%3,55). Hastaların tekrar geldikleri bölümler incelendiğinde en fazla 19 (%32,2) hasta Genel Cerrahi Kliniği’ndendi. Tekrar kabul edilen hastaların 22’si (%37,29) taburcu edildikten sonraki ilk 48 saat içinde gerçekleşti. Tekrar kabul edilen hastaların en sık nedenleri; revizyon cerrahisi sonrasında postoperatif monitorizasyon (%44,07) ve akut solunum yetersizliği (%40,68) olarak belirlendi.
Sonuç:
YBÜ’den taburcu edilen hastalar, tekrar YBÜ’ye kabul için yüksek risk altındadırlar. Yoğun bakım ünitesine geri kabul, ilk kabulden çok daha yüksek mortalite oranları ile ilişkilidir. YBÜ’ye geri kabul oranlarını azaltmadaki önemli adım, önceden hastaları tanımak, tanımlamak ve servis bakım düzeylerini yükseltmektir.
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