Med J Bakirkoy. 2020; 16(4): 406-411 | DOI: 10.5222/BMJ.2020.41275

Comparison of Immigrants and Turkish Patients in Terms of Malnutrition and its Effects on Mortality among patients hospitalized in the ICU with Gastrointestinal Cancers

Begüm Þeyda Avci¹, Adnan Kuvvetli², Alper Parlakgumus^3
1Health Science University, Adana City Research and Training Hospital, Department of Internal Medicine, Adana, Turkey
²Health Science University, Adana City Research And Training Hospital, Department Of Surgery, Adana, Turkey
³Health Science University, Adana City Research And Training Hospital, Department Of Surgical Oncology, Adana, Turkey

Objective: The aim of this study was to compare the effects of malnutrition on mortality in immigrants and Turkish patients
hospitalized in our ICU with the indication of gastrointestinal cancer.
Method: This study was performed as a prospective observational study. One-hundered and three (41.3%) patients were Turkish and
146 (58.7%) were immigrants (all Syrian). Age, body mass index (BMI), duration of hospitalization, albumin value, and 30-day and
6-month mortality rates were evaluated. Also, the following assessment tools were calculated: Subjective Global Assessment (SGA),
Nutrition risk screening-2002 (NRS), Charlson Comorbidity Index (CCI) Acute Physiology and Chronic Health Evaluation (APACHE) II
and III.
Results: In total, 150 (60.2%) patients had moderate (SGA B), while 71 (28.5%) patients had severe malnutrition (SGA C). The
frequency of SGA C in the immigrants was significantly higher than Turkish ciitzens (p=0.004). The overall mortality rate in our study
was 36.9%. No significant difference was found between Turkish citizens and immigrants in terms of overall mortality (p=0.592).
Albumin value, APACHE II, APACHE III, CCI and NRS scores were significantly higher in those that died within 30 days. The APACHE 3
score was the most successful tool in predicting 30-day mortality according to ROC analyses.
Conclusion: This study revealed that malnutrition is a significant problem for both immigrants and Turkish citizens hospitalized in the
ICU. Although there are tools specific for malnutrition assessment, APACHE III score was found to have the highest likelihood to
predict mortality.

Keywords: malnutrition, immigrants, subjective global assessment, mortality

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Yoðun Bakým Ünitesinde Gastrointestinal Kanser ile Yatan Hastalarda Malnutrisyon ve Mortalite Üzerindeki Etkileri Açýsýndan Göçmen ve Türk Hastalarýn Karþýlaþtýrýlmasý

Begüm Þeyda Avci¹, Adnan Kuvvetli², Alper Parlakgumus^3
1Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim ve Araþtýrma Hastanesi, Ýç Hastalýklarý Kliniði, Adana, Türkiye
²Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim Ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Adana, Türkiye
³Saðlýk Bilimleri Üniversitesi, Adana Þehir Eðitim Ve Araþtýrma Hastanesi, Onkolojik Cerrahi Kliniði, Adana, Türkiye

Amaç: Bu çalýþmanýn amacý, mide baðýrsak kanseri nedeniyle yoðun bakým ünitemize yatýrýlan göçmen ve Türk hastalarda malnütrisyonun
mortalite üzerindeki etkilerini karþýlaþtýrmaktýr.
Yöntem: Bu çalýþma ileriye dönük gözlemsel çalýþma olarak yapýldý. Hastalarý 103’ü Türk (% 41,3), 146'sý (% 58,7) göçmendi (Tümü
Suriyeli). Yaþ, vücut kitle indeksi (VKÝ), hastanede kalýþ süresi, albümin deðeri ve 30 günlük ve 6 aylýk mortalite deðerlendirildi. Ayrýca,
aþaðýdaki deðerlendirme skorlamalarý hesaplandý: Subjektif Global Deðerlendirme (SGA), Nütrisyon Risk Deðerlendirmesi-2002 (NRS),
Charlson Komorbidite Ýndeksi (CCI) Akut Fizyoloji ve Kronik Saðlýk Deðerlendirmesi (APACHE) II ve III.
Bulgular: Toplamda 150 (% 60,2) hastada orta düzeyde yetersiz beslenme (SGA B) varken 71 (% 28,5) hastada þiddetli beslenme
bozukluðu (SGA C) vardý. Göçmenlerde SGA C sýklýðý Türk vatandaþlarýna göre anlamlý olarak daha yüksekti (p = 0,004). Çalýþmamýzdaki
genel ölüm oraný% 36,9'du. Genel ölüm oranlarý açýsýndan Türk vatandaþlarý ve göçmenler arasýnda anlamlý bir fark bulunmadý (p =
0.592). 30 gün içinde ölenlerde albümin deðeri, APACHE II, APACHE III, CCI ve NRS skorlarý anlamlý olarak yüksekti. APACHE 3 skoru,
ROC analizlerine göre 30 günlük mortaliteyi tahmin etmede en baþarýlý olanýydý.
Sonuç: Bu çalýþma yetersiz beslenmenin hem göçmenler hem de yoðun bakým ünitesinde yatan Türk vatandaþlarý için önemli bir sorun
olduðunu ortaya koymuþtur. Yetersiz beslenme deðerlendirmesi için özel araçlar olmasýna raðmen, APACHE III skorunun mortaliteyi
tahmin etme olasýlýðýnýn en yüksek olduðu bulunmuþtur.

Anahtar Kelimeler: malnütrisyon, göçmenler, subjektif global deðerlendirme, mortalite

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