بررسی ارتباط اسیدوز با اختلالات انعقادی در بیماران تحت لاپاراتومی بستری در بخش مراقبت‌های ویژه

زمینه و هدف: کواگولوپاتی یکی از شایعترین علل مرگ‌ومیر در بخش مراقبت‌های ویژه است. این مطالعه نیز با هدف بررسی ارتباط اسیدوز با اختلالات انعقادی در بیماران تحت لاپاراتومی بستری در بخش مراقبت‌های ویژه اجرا شد.روش بررسی: در این مطالعه مقطعی گذشته‌نگر پرونده 121 نفر از بیماران تحت لاپاراتومی بستری در بخش مراقبت‌های ویژه بیمارستان امام‌خمینی (ره) شهر اهواز طی سال 1402 بررسی شده و اطلاعات دموگرافیک، بالینی و نتایج آزمایش‌خون برای اندازه‌گیری پارامترهای مرتبط با اسیدوز و آزمایش‌های انعقادی افراد استخراج شد. در ادامه نرخ کواگولوپاتی، ترومبوسیتوپنی، اسیدوز و پیامد بیمار محاسبه شد. یافته‌ها: پرفشاری خون 34(28.1%) مهمترین بیماری‌همراه و پریتونیت 54(44.6%) مهمترین علل بستری بیماران را تشکیل دادند. نرخ بروز کوآگولوپاتی، ترومبوسیتوپنی و اسیدوز به‌ترتیب 29(24%)، 27(22.3%) و 115(95%) گزارش گردید. در مجموع 44(36.5%) بیمار در طی دوره بررسی فوت شدند. بااینکه نرخ کوآگولوپاتی و ترومبوسیتوپنی در بیماران دچاراسیدوز بالاتر بود اما این تفاوت‌ها معنادار نبود (0.05

study of the relationship between acidosis and coagulation disorders in patients undergoing laparotomy admitted to the intensive care unit

background: coagulopathy is one of the most common causes of mortality in the intensive care unit. this study was designed and implemented to investigate the relationship between acidosis and coagulation disorders in patients undergoing laparotomy in the intensive care unit.methods: this retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of imam khomeini hospital of ahvaz during 2024. demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. the data obtained were analyzed using spss version 27 software.results: most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. the incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. a total of 44 (36.5%) patients died during the study period. although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (p<0.05). the mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (p=0.001). the mean ph in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; p=0.005). the mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); p=0.000).conclusion: the incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. however, acidosis was not found to be an independent risk factor for coagulation disorders in this population. further research is necessary to confirm or refute these findings.