Evaluation of clinical features and the factors related to nutrition in home care patients with pressure ulcer

Introduction: In this study, we aimed to determine the demographic and clinical characteristics of patients with pressure ulcers who received home health care in Kutahya city and to investigate the relationship between the factors related to nutrition and pressure ulcer grades. Methods: This study is designed as a retrospective and cross-sectional. The files of 500 patients who were registered at home health services unit of Kutahya Health Sciences University Training and Research Hospital between December 2016 and May 2017 were reviewed retrospectively. Of these, sixty-three patients with pressure ulcers were included in the study. Results: In this study, 26 (41.3%) were male and 37 (58.7%) were female. The mean age of the patients with pressure ulcers was 74.41 ± 12.30 (years). 36 patients (57.1%) had cerebrovascular disease, 5 patients (7.9%) had dementia, 9 patients (14.3%) had malignancy, 8 patients (12.7%) had osteoarthritis, 4 patients 6.3%) had peripheral vascular disease, and 1 patient (1.6%) had previous traffic accident. The majority (62.1%) were neurological disease-sequenced and nursing-care group. When all the patients were examined, the region with the most pressure was the sacrum (35.3%). Hemoglobin level was found to be related to pressure ulcer grade (One-way ANOVA, p = 0.019). There was no significant relationship between other nutrition-related parameters and pressure ulcer stage. Conclusion: Patients with cerebrovascular disease constitute a significant proportion of patients receiving home care services. Low hemoglobin increases the severity of the pressure ulcer. Therefore, determining risk factors that contribute to pressure ulcer formation and efforts to prevent them should be the primary target of the home health care unit

Evaluation of Time in Therapeutic Range in Patients with Cerebrovascular Disease Receiving Treatment with Warfarin

Objective: The efficacy of warfarin therapy correlates with the Time in Therapeutic Range (TTR). This study aimed to investigate the efficacy and target achievement rates in patients using warfarin who were followed up in stroke outpatient clinics.Methods: In this study, 103 patients who had been under warfarin treatment were retrospectively evaluated. Duration and indications for warfarin use, thrombotic or hemorrhagic complications were recorded. Target INR value was 3.0-3.5 in patients with mechanical valves and 2.0-3.0 in those using warfarin for other indications.Results: In this study, 103 patients with a mean age of 67.14±14.19, 47 men and 56 women, were included. Indications for warfarin use, respectively, were non-valvular atrial fibrillation (AF) in 61.6% of the patients, akinetic/hypokinetic segment on echocardiography (ECHO) in 12.62%, thrombophilia in 8.74%, metallic prosthetic valve in 3.88%, frequent transient ischemic attacks in 6.79%, a hypokinetic segment on ECHO with atrial fibrillation in 5.82% and vertebral artery dissection in 0.87%. 46.8% of the patients were determined to be in good control, with a mean TTR of 64.09%; also, TTR was 100% in 36.8% of them. Minor/major hemorrhagic event was noted in 10 patients (9.70%), two of whom had an intracerebral hemorrhage.Conclusion: The mean TTR value detected in this study is considerably higher than the rate reported in our country. Findings of this study suggest that close monitoring is paramount of importance and vital in patients with stroke. Regular monitoring of stroke patients using warfarin will be beneficial in terms of informing patients, providing optimal anticoagulation and preventing complications

The Effect of Mannitol Treatment on Renal Functions in Acute Stroke

OBJECTIVE: Mannitol is an osmotic diuretic agent and reduces intracranial pressure. The most serious side effect of mannitol is kidney dysfunction. In this study, renal functions in acute stroke patients treated with mannitol were evaluated. METHODS: One hundred and twenty-two patients followed in the neurology intensive care unit with the diagnosis of stroke and treated with fractionated mannitol for 5 days were evaluated retrospectively. Ninety-six patients had ischemic and 26 had hemorrhagic stroke. Mean age was 69.9 ± 11.8 (18-91) years. Serum urea, creatinine and electrolyte levels measured before and on the second, third, fourth, fifth and tenth days of treatment were compared statistically with paired sample t test. RESULTS: The average urea and creatinine levels on the second, third, fourth and fifth days of treatment were significantly higher than the baseline (p< 0.05). On the other hand, mannitol treatment did not change average sodium, potassium and chlorine levels. The creatinine levels had returned to the normal range on the tenth day of treatment, but the urea levels, although decreased, did not fall to the normal range. CONCLUSION: Our results support the view that close monitoring of renal function is necessary in patients treated with mannito

The Effect of Mannitol Treatment on Renal Functions in Acute Stroke

OBJECTIVE: Mannitol is an osmotic diuretic agent and reduces intracranial pressure. The most serious side effect of mannitol is kidney dysfunction. In this study, renal functions in acute stroke patients treated with mannitol were evaluated. METHODS: One hundred and twenty-two patients followed in the neurology intensive care unit with the diagnosis of stroke and treated with fractionated mannitol for 5 days were evaluated retrospectively. Ninety-six patients had ischemic and 26 had hemorrhagic stroke. Mean age was 69.9 ± 11.8 (18-91) years. Serum urea, creatinine and electrolyte levels measured before and on the second, third, fourth, fifth and tenth days of treatment were compared statistically with paired sample t test. RESULTS: The average urea and creatinine levels on the second, third, fourth and fifth days of treatment were significantly higher than the baseline (p< 0.05). On the other hand, mannitol treatment did not change average sodium, potassium and chlorine levels. The creatinine levels had returned to the normal range on the tenth day of treatment, but the urea levels, although decreased, did not fall to the normal range. CONCLUSION: Our results support the view that close monitoring of renal function is necessary in patients treated with mannitol

Evaluation of clinical features and the factors related to nutrition in home care patients with pressure ulcer

AbstractIntroduction: In this study, we aimed to determine the demographic and clinical characteristics of patients with pressure ulcers who receivedhome health care in Kutahya city and to investigate the relationship between the factors related to nutrition and pressure ulcer grades.Methods: This study is designed as a retrospective and cross-sectional. The files of 500 patients who were registered at home health services unitof Kutahya Health Sciences University Training and Research Hospital between December 2016 and May 2017 were reviewed retrospectively. Ofthese, sixty-three patients with pressure ulcers were included in the study.Results: In this study, 26 (41.3%) were male and 37 (58.7%) were female. The mean age of the patients with pressure ulcers was 74.41 ± 12.30(years). 36 patients (57.1%) had cerebrovascular disease, 5 patients (7.9%) had dementia, 9 patients (14.3%) had malignancy, 8 patients (12.7%)had osteoarthritis, 4 patients 6.3%) had peripheral vascular disease, and 1 patient (1.6%) had previous traffic accident. The majority (62.1%) wereneurological disease-sequenced and nursing-care group. When all the patients were examined, the region with the most pressure was the sacrum(35.3%). Hemoglobin level was found to be related to pressure ulcer grade (One-way ANOVA, p = 0.019). There was no significant relationshipbetween other nutrition-related parameters and pressure ulcer stage.Conclusion: Patients with cerebrovascular disease constitute a significant proportion of patients receiving home care services. Low hemoglobinincreases the severity of the pressure ulcer. Therefore, determining risk factors that contribute to pressure ulcer formation and efforts to preventthem should be the primary target of the home health care unit.Keywords: Pressure ulcer, home care services, nutritional status</p

Evaluation of clinical features and the factors related to nutrition inhome care patients with pressure ulcer

AbstractIntroduction: In this study, we aimed to determine the demographic and clinical characteristics of patients with pressure ulcers who receivedhome health care in Kutahya city and to investigate the relationship between the factors related to nutrition and pressure ulcer grades.Methods: This study is designed as a retrospective and cross-sectional. The files of 500 patients who were registered at home health services unitof Kutahya Health Sciences University Training and Research Hospital between December 2016 and May 2017 were reviewed retrospectively. Ofthese, sixty-three patients with pressure ulcers were included in the study.Results: In this study, 26 (41.3%) were male and 37 (58.7%) were female. The mean age of the patients with pressure ulcers was 74.41 ± 12.30(years). 36 patients (57.1%) had cerebrovascular disease, 5 patients (7.9%) had dementia, 9 patients (14.3%) had malignancy, 8 patients (12.7%)had osteoarthritis, 4 patients 6.3%) had peripheral vascular disease, and 1 patient (1.6%) had previous traffic accident. The majority (62.1%) wereneurological disease-sequenced and nursing-care group. When all the patients were examined, the region with the most pressure was the sacrum(35.3%). Hemoglobin level was found to be related to pressure ulcer grade (One-way ANOVA, p = 0.019). There was no significant relationshipbetween other nutrition-related parameters and pressure ulcer stage.Conclusion: Patients with cerebrovascular disease constitute a significant proportion of patients receiving home care services. Low hemoglobinincreases the severity of the pressure ulcer. Therefore, determining risk factors that contribute to pressure ulcer formation and efforts to preventthem should be the primary target of the home health care unit.Keywords: Pressure ulcer, home care services, nutritional status</p