Kardiyak Cerrahi Planlanan Kırılgan Geriatrik Hastalarda Perioperatif Hemşirelik Yaklaşımları


Özet Görüntüleme: 43 / PDF İndirme: 19

Yazarlar

DOI:

https://doi.org/10.5281/zenodo.17715436

Anahtar Kelimeler:

Kırılganlık Sendromu, Geriatrik Hasta, Kardiyak Cerrahi, Perioperatif, Hemşirelik Yaklaşımları

Özet

Kardiyak cerrahi hayat kurtarıcı tedavi yöntemi olmakla birlikte geriatrik bireylerde bazı komplikasyonların gelişme riskini de beraberinde getirmektedir.  Bu riskin ortaya çıkmasında birden fazla neden bulunmaktadır. En önemli risk nedenlerinden biri “Kırılganlık Sendromu’dur”. Kırılganlık sendromu mobilitede bozulma, hormonal değişiklikler, kilo kaybı, kas gücü ve hacminde azalma (sarkopeni), denge bozukluğu gibi fizyolojik rezervlerdeki azalma olarak tanımlanmaktadır.  Kırılganlık, özellikle kardiyak cerrahi gibi yüksek riskli girişimlerde perioperatif sonuçları olumsuz etkileyen önemli bir faktördür.  Bu hasta grubunda azalan fizyolojik rezerv nedeniyle “morbidite ve mortalite” riski daha da yüksektir. Bu nedenle ameliyat öncesi kırılgan hastaların belirlenmesi ve olası komplikasyonların önlenmesine yönelik hemşirelik yaklaşımlarının yerine getirilmesi önemli bir kriterdir. Bu nedenle, bu derlemede söz konusu hasta grubunda perioperatif hemşirelik yaklaşımları ele alındı.

Referanslar

Aceto, P., Antonelli Incalzi, R., Bettelli, G., Carron, M., Chiumiento, F., Corcione, A., ... & Volpato, S. (2020). Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus. Aging Clinical and Experimental Research, 32(9), 1647-1673.

Afilalo, J., Lauck, S., Kim, D. H., Lefevre, T., Piazza, N., Lachapelle, K., ... & Perrault, L. P. (2017). Frailty in older adults undergoing aortic valve replacement: the FRAILTY-AVR study. Journal of the American College of Cardiology, 70(6), 689-700.

Akbuğa, G. A., Bahçeli, A. (2017). Kalp Cerrahisi Girişimi Uygulanan Yaşlı Bireylere Yönelik Bakım. Bozok Tıp Dergisi, 7(2): 71-76.

Arabacı, S., Karaman, S. T., Basat, O. (2023). Yaşlıların Sağlık Durumları ile Kırılganlık Düzeylerinin Değerlendirilmesi ve Yaşam Kalitesi ile İlişkisinin İncelenmesi. Turkish Journal of Family Medicine and Primary Care, 17(2): 324-332.

Arthur, H. M., Daniels, C., McKelvie, R., Hirsh, J., & Rush, B. (2000). Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery: a randomized, controlled trial. Annals of internal medicine, 133(4), 253-262.

Bhardwaj, D., (2021). The Influence of Frailty in Elderly Patients on Postoperative Outcomes After Elective Cardiac Surgery. Master's thesis, Lithuanian University of Health Sciences, Ulaşım Linki: https://www.proquest.com/dissertations-theses/influence-frailty-elderly-patients-on/docview/3098808797/se-2 Erişim tarihi: 13.05.2025.

Brown IV, C. H., Max, L., LaFlam, A., Kirk, L., Gross, A., Arora, R., ... & Pustavoitau, A. (2016). The association between preoperative frailty and postoperative delirium after cardiac surgery. Anesthesia & Analgesia, 123(2), 430-435.

Chandiramani, A., & Ali, J. M. (2025). Frailty in Cardiac Surgery—Assessment Tools, Impact on Outcomes, and Optimisation Strategies: A Narrative Review. Journal of Cardiovascular Development and Disease, 12(4), 127.

Demirarslan, E., (2017). Ameliyat Sonrası Hipotermi Kontrolü. Sağlık Akademisi Kastamonu, 2(1): 51-70.

Denfeld, Q. E., Jha, S. R., Fung, E., Jaarsma, T., Maurer, M. S., Reeves, G. R., … & Afilalo, J., (2024). Assessing and managing frailty in advanced heart failure: an International Society for Heart and Lung Transplantation consensus statement. The Journal of Heart and Lung Transplantation, 43(1): 1-27.

Deng, Y., Sato, N., (2024). Global frailty screening tools: review and application of frailty screening tools from 2001 to 2023. Intractable & Rare Diseases Research, 13(1): 1-11.

Eyigor, S., Kutsal, Y. G., Duran, E., Huner, B., Paker, N., Durmus, B., … & Sahin, N., (2015) Turkish Society of Physical Medicine and Rehabilitation, Geriatric Rehabilitation Working Group, 2015, Frailty prevalence and related factors in the older adult-Frail-TURK Project, 37(3): 50.

Frailty Guideline Working Group. (2021). Guideline for perioperative care for people living with frailty undergoing elective and emergency surgery. Centre for Perioperative Care and the British Geriatrics Society, Royal College of Anaesthetists. Ulaşım linki: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.rcseng.ac.uk/-/media/files/rcs/fds/guidelines/cpoc-frailty-guideline-launch-28-september-2021.pdf Ulaşım Tarihi: 24.11.2025

Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., ... & McBurnie, M. A. (2001). Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(3), M146-M157.

Görey, C. N., Kahraman, S., Çelik, F. (2024). Yaşlılarda Kırılganlık Sendromu ve Beslenme. Akdeniz Tıp Dergisi, 11(1): 149-156.

Graham, A., Brown IV, C. H., (2017). Frailty, aging, and cardiovascular surgery. Anesthesia & Analgesia, 124(4): 1053-1060.

Health Programme of the European Union. (2018). Advantage managing frailty, ADVANTAGE Joint Action Layman report of the State of the Art report on frailty prevention and management, Erişim linki: https://www.regione.marche.it/Portals/3/Aree_attivita/Area_ricerca/ADVANTAGE_Stato%20dell_arte.pdf?ver=2018-08-03-085829-323#:~:text=by%20ADVAN TAGE%20JA%3F-,1,outcomes%20(WHO%2C%202015) Erişm tarihi: 28.10.2025

Hendry, A., Carriazo, A. M., Vanhecke, E., & Rodríguez-Laso, Á. (2018). Integrated care: a collaborative advantage for frailty. International journal of integrated care, 18(2), 1.

Jin, N., Gu, T., Song, S., Yao, J., & Pang, X. (2025). Enhanced recovery in cardiac surgery patients with frailty through comprehensive perioperative nursing interventions: A randomized controlled trial. Clinical Rehabilitation, 39(5), 632-645.

Jung, P., Pereira, M. A., Hiebert, B., Song, X., Rockwood, K., Tangri, N., & Arora, R. C. (2015). The impact of frailty on postoperative delirium in cardiac surgery patients. The Journal of thoracic and cardiovascular surgery, 149(3), 869-875.

Koh, L. Y., & Hwang, N. C. (2019). Frailty in cardiac surgery. Journal of cardiothoracic and vascular anesthesia, 33(2), 521-531.

Korkmaz, F. D., & Arıkan, B. (2022). Nursing care of frail patients in cardiac surgery. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 11(2), 806-816.

Köleoğlu, Ş. (2024). Kronik Hastalıkların Yönetimi: Farklı Yaklaşımlar ve Uygulamalar (Ed: Sürücü, H. A). Kronik Hastalığı Olan Yaşlılarda Görülen Sendromlar ve Yönetimi, İksad Yayınevi, Ankara, s.15-50.

Lee, J. A., Yanagawa, B., An, K. R., Arora, R. C., Verma, S., Friedrich, J. O., & Canadian Cardiovascular Surgery Meta-Analysis Working Group. (2021). Frailty and pre-frailty in cardiac surgery: a systematic review and meta-analysis of 66,448 patients. Journal of cardiothoracic surgery, 16(1), 184.

Mohanty, S., Rosenthal, R. A., Russell, M. M., Neuman, M. D., Ko, C. Y., & Esnaola, N. F. (2016). Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. Journal of the American College of Surgeons, 222(5), 930-947.

Olotu, C., Weimann, A., Bahrs, C., Schwenk, W., Scherer, M., & Kiefmann, R. (2019). The perioperative care of older patients: time for a new, interdisciplinary approach. Deutsches Ärzteblatt International, 116(5), 63.

Özşaker, E. (2023). Yaşlı cerrahi hastaları ve kırılganlık sendromu. Samsun Sağlık Bilimleri Dergisi, 8(1), 49-62.

Paille, M., Senage, T., Roussel, J. C., Manigold, T., Piccoli, M., Chapelet, G., ... & Boureau, A. S. (2021). Association of preoperative geriatric assessment with length of stay after combined cardiac surgery. The Annals of Thoracic Surgery, 112(3), 763-769.

Pozzi, M., Mariani, S., Scanziani, M., Passolunghi, D., Bruni, A., Finazzi, A., ... & Marchetto, G. (2023). The frail patient undergoing cardiac surgery: lessons learned and future perspectives. Frontiers in Cardiovascular Medicine, 10, 1295108.

Radhakrishnan, S. N., 2019. The Impact of Frailty on Outcomes after Cardiac Surgery. Master's thesis, Lithuanian University of Health Sciences, Lithuania. Erişim Linki: https://www.proquest.com/docview/3098799136?pq-origsite=gscholar&fromopenview=true&sourcetype=Dissertations%20&%20Theses Erişim Tarihi: 24.05.2025.

Rezaei-Shahsavarloo, Z., Atashzadeh-Shoorideh, F., Gobbens, R. J., Ebadi, A., & Ghaedamini Harouni, G. (2020). The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis. BMC geriatrics, 20(1), 526.

Rodríguez-Laso, A., Mora, M. Á. C., Sánchez, I. G., Bouzón, C. A., Mañas, L. R., Bernabei, R., ... & Targowski, T. (2019). Updated state of the art report on the prevention and management of frailty. Health Programme of the European Union. Erişim linki: https://www.sanidad.gob.es/gl/areas/promocionPrevencion/envejecimientoSaludable/fragilidadCaidas/estrategiaSNS/docs/Updated_state_of_the_art_report_on_the_prevention_and_management_of_frailty.pdf Erişm tarihi: 28.10.2025

Rodríguez-Mañas, L., Féart, C., Mann, G., Viña, J., Chatterji, S., Chodzko-Zajko, W., ... & FOD-CC group (Appendix 1). (2013). Searching for an operational definition of frailty: a Delphi method based consensus statement. The frailty operative definition-consensus conference project. Journals of gerontology series a: biomedical sciences and medical sciences, 68(1), 62-67.

Sarı, M. K., & Durna, Z. (2022). Geriatrik sendromlar ve bakım. ERÜ Sağlık Bilimleri Fakültesi Dergisi, 9(1), 39-46.

Sepehri, A., Beggs, T., Hassan, A., Rigatto, C., Shaw-Daigle, C., Tangri, N., & Arora, R. C. (2014). The impact of frailty on outcomes after cardiac surgery: a systematic review. The Journal of thoracic and cardiovascular surgery, 148(6), 3110-3117.

Shanker, A., Upadhyay, P., Rangasamy, V., Muralidhar, K., & Subramaniam, B. (2021). Impact of frailty in cardiac surgical patients—Assessment, burden, and recommendations. Annals of Cardiac Anaesthesia, 24(2), 133-139.

Starr, R., & Stefan, M. (2016). Perioperative assessment of and care for the elderly and frail. Hospital Medicine Clinics, 5(2), 224-241.

TÜİK Aktif Yaşlanma Endeksi, 2024. (2025). https://data.tuik.gov.tr/Bulten/Index?p=Aktif-Yaslanma-Endeksi-2024-57937 Erişim Tarihi: 26.06.2025

World Health Organization (2015). World report on ageing and health. Erişim linki: https://www.who.int/docs/default-source/mca-documents/ageing/9789240694811-eng.pdf Erişm Tarihi: 28.06.2025.

World Health Organization. Ageing and health (2025). https://www.who.int/news-room/fact-sheets/detail/ageing-and-health Erişim tarihi: 26.05.2025.

Yoltay, H. E., Korkmaz, F. D., 2021. Kalp Cerrahisinde Kırılgan Hasta ve Hemşirelik Bakımı. Instıtute of Health Sciences Journal, 6(2): 82-92.

İndir

Yayınlanmış

01.12.2025

Nasıl Atıf Yapılır

GÖK, F., & DEMİR ÖZCAN , D. (2025). Kardiyak Cerrahi Planlanan Kırılgan Geriatrik Hastalarda Perioperatif Hemşirelik Yaklaşımları. Euroasia Matematik, Mühendislik, Doğa Ve Tıp Bilimleri Dergisi Medical Sciences, 12(3), 490–504. https://doi.org/10.5281/zenodo.17715436

Sayı

Bölüm

Makaleler