�stanbul Genelinde Sa�l�k Personeline Verilen �nme E�itimlerinin Etkinli�i

Korkut, Semih; Sertba�, Ya�ar; Arslan, Elif; Da�c�, Selma; T�rkdo�an, Kenan Ahmet

Cilt : 35 Say� : 1 Y�l : 2024

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�stanbul Genelinde Sa�l�k Personeline Verilen �nme E�itimlerinin Etkinli�i [South Clin Ist Euras]

South Clin Ist Euras. 2020; 31(4): 356-361 | DOI: 10.14744/scie.2020.83723

�stanbul Genelinde Sa�l�k Personeline Verilen �nme E�itimlerinin Etkinli�i

Semih Korkut¹, Ya�ar Sertba�², Elif Arslan³, Selma Da�c�⁴, Kenan Ahmet T�rkdo�an⁵
¹Kartal Dr. Lutfi Kirdar E�itim Ve Ara�t�rma Hastanesi,acil T�p Anabilim Dal�, �stanbul
²Fatih Sultan Mehmet E�itim Ve Ara�turma Hastanesi, �� Hastal�klar� Anabilim Dal�, �stanbul
³�stanbul �l Sa�l�k M�d�rl��, Acil Sa�l�k Hizmetleri Ba�kanl��, �stanbul
⁴�stanbul �l Sa�l�k M�d�rl��, Sa�l�k Hizmetleri Ba�kanl��, �stanbul
⁵Ba�c�lar E�itim Ve Ara�t�rma Hastanesi, Acil T�p Anabilim Dal�, �stanbul

G�R�� ve AMA�: �nme, zamana ba�l� tedavisi ile morbidite ve mortalitenin en s�k nedenlerinden biridir. Tedavinin �nündeki en büyük engel, hastane �ncesi ula��m gecikmeleri, doku plazminojen aktivat�rü (IV-tPA) ve mekanik trombektomi (MT) ile tedavide tereddüt etmektir. �stanbul�da bu sorunlar� ve inme tedavisinin �nündeki engelleri ortadan kald�rmak i�in farkl� e�itim faaliyetleri ger�ekle�tirilmi�tir. �al��mam�zda bu aktivitelerin tedavi sürecine yans�malar�n� g�stermeyi ama�lad�k.
Y�NTEM ve GERE�LER: Bu �al��ma, �stanbul�daki 2645 sa�l�k personeline inme tedavisi organize etmek amac�yla verilen e�itim programlar�n�n etkinli�ini g�rmek i�in geriye d�nük olarak tasarlanm��t�r. �al��mam�zda, e�itimlerin sonunda 2017�2018 y�llar� i�indeki bir ayl�k periyotta nakil süreleri, inme tan�s� i�in do�ruluk oranlar� ve tedavi parametreleri aras�ndaki de�i�ikli�i inceledik
BULGULAR: Bu �al��mada, 1�31 Ekim 2017 (n=796) ve 1�31 Ekim 2018 (n=832) tarihleri aras�nda inmeden �üphelenilen ve ambulansla hastaneye nakledilen 1628 hastay� de�erlendirdik. Hastane �ncesi ula��m sürelerinde minimal fakat anlaml� dü�ü�ler vard� (p<0.05). �nme �üphesi ile hastaneye sevk edilen hastalar�n 2017 y�l�nda %27�sinde akut inme tan�s� konmas�na ra�men, 2018�de bu rakam %36 idi (p<0.05). Akut inme hastalar�na iv-tPA ve MT uygulamalar� da 2018�de 2017�ye g�re �nemli �l�üde artm��t�r (IV-tPA i�in %14�e kar�� %26 p=0.003 ve MT i�in %6�ya kar�� %13, p=0.034).
TARTI�MA ve SONU�: Analizlerimiz, inme tan�s� konmas�nda, tPA kullan�m�nda ve mekanik trombektomideki belirgin art��lar ile e�itim programlar�n�n hedeflerine ba�ar�yla ula�t�klar�n� g�stermi�tir.

Anahtar Kelimeler: Doku plazminojen aktivat�r, hastane �ncesi transpot, inme; inme tedavisi; mekanik trombektomi.

Effectiveness of Stroke Training Provided to Istanbul Medical Staff

Semih Korkut¹, Ya�ar Sertba�², Elif Arslan³, Selma Da�c�⁴, Kenan Ahmet T�rkdo�an⁵
¹Department of Emergency, University of Health Sciences, Kartal Dr. Lütfi K�rdar Training and Research Hospital, �stanbul, Turkey
²Department of Internal Medicine, Fatih Sultan Mehmet Training and Research Hospital, �stanbul, Turkey
³Department of Emergency Health Services, �stanbul Provincial Health Directorate, �stanbul, Turkey
⁴Department of Health Services, �stanbul Provincial Healt Directorate, �stanbul, Turkey
⁵Department of Emergency, Ba�c�lar Training and Research Hospital, Medicine, �stanbul, Turkey

INTRODUCTION: Stroke is one of the most common causes of morbidity and mortality in the world and therapy is time-sensitive. The biggest obstacles to optimal treatment are pre-hospital transport delays and hesitation to administer intravenous tissue plasminogen activator (iv-tPA) and perform a mechanical thrombectomy (MT). A number of educational sessions were held in Istanbul to address these problems. This study examined the effects of this training.
METHODS: This retrospective study was designed to analyze the effectiveness of stroke treatment training programs provided to 2645 medical personnel in Istanbul, Turkey. The transport time, accuracy rate of stroke diagnosis, and treatment parameters of a 1-month period in 2017 and the same month in 2018 after the training were evaluated.
RESULTS: In all, 1628 suspected stroke patients who were transported to a hospital by ambulance in October 2017 (n=796) and October 2018 (n=832) were included. There was a minimal but meaningful decrease in pre-hospital transportation time (p<0.05). In 2017, 27% of the patients who were transported to the hospital with the suspicion of stroke were ultimately diagnosed with acute stroke, while 36% were diagnosed with acute stroke in 2018 (p<0.05). Applications of iv-tPA and MT to acute stroke patients also significantly increased in 2018 (tPA: 14% vs 26%, p=0.003; MT: 6% vs 13%, p=0.034).
DISCUSSION AND CONCLUSION: The analysis indicated that the educational programs targets were successful based on an increase in the diagnosis of stroke and use of iv-tPA and MT.

Keywords: Mechanical thrombectomy, prehospital transportation, stroke; stroke treatment; tissue plasminogen activator.

Semih Korkut, Ya�ar Sertba�, Elif Arslan, Selma Da�c�, Kenan Ahmet T�rkdo�an. Effectiveness of Stroke Training Provided to Istanbul Medical Staff. South Clin Ist Euras. 2020; 31(4): 356-361

Sorumlu Yazar: Ya�ar Sertba�, T�rkiye
Makale Dili: �ngilizce

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