Ram Mohan, (2023) To Determine the Prognostic Factors in Acute Pulmonary Edema in a Tertiary Care Hospital. Masters thesis, Stanley Medical College, Chennai.
Full text not available from this repository.Abstract
BACKGROUND: Acute pulmonary edema is a medical emergency requiring immediate management. It is characterised by dyspnea and hypoxia secondary to fluid accumulation in the lungs which impairs gas exchange and lung compliance. It can be due to either cardiogenic causes or non-cardiogenic causes. Postdischarge 1-year mortality can be 25-30% with up to more than 45% deaths or readmission rates. Prompt diagnosis of the cause of acute pulmonary edema with immediate management is required to ensure patient survival. In this study we would like to determine the prognostic factors in acute cardiogenic pulmonary edema and using these factors identify management techniques that would improve short term outcomes. AIM OF THE STUDY: To determine the prognostic factors in Acute pulmonary edema in a tertiary care hospital OBJECTIVES: 1. To determine and classify the prognostic factors in acute pulmonary edema using clinical, biochemical, radiological information. 2. To identify the management techniques which improve short term outcome in patients with acute pulmonary edema MATERIALS AND METHODS: This is a prospective observational type of study where 75 patients admitted with Acute pulmonary edema in the Emergency Medical Unit, Department of General Medicine and Department of Cardiology in Government Stanley Medical College and Hospital were enrolled in the study. The study was conducted over a period of six months and patients were followed up after 1 month of discharge. Data regarding the clinical, biochemical and echocardiographic, radiological investigations and in-hospital management were collected and analysed in order to identify possible prognostic factors. RESULTS: 58.7% of the study population were males and 41.3% were females. The predominant age group was the 50-75 years age group with 80% total representation. 66.7% were Hypertensives, 60% were Diabetics, 46.7% had Coronary artery disease, 22.7% had Chronic Kidney Disease and 25.3% had other comorbidities also. Good prognostic factors included higher admission systolic and diastolic blood pressures BP > 180/100 mmHg, mean serum albumin level >3.5g/dl, and those treated with intravenous diuretics and intravenous nitroglycerine fared better. Poor prognostic factors included age above 60 years, higher mean pulse rate >125/min on admission, Spo2 <90% on admission, the presence of cyanosis and S3 on Cardiovascular Examination and altered mentation. Higher levels of Serum CRP, Triglycerides and CKMB and a lower LV ejection fraction served as independent risk factors of poor outcomes. CONCLUSION: Acute Pulmonary Edema is a medical emergency and requires early diagnosis and timely emergency care for ensuring a favourable outcome. The results of this study will help in the early identification of high risk individuals and will provide physicians with crucial information on who to treat more aggressively and mobilize resources faster. This will help to improve the short term outcomes and reduce mortality. In a medical emergency every minute detail makes a difference and this study provides many insights on how we can improve patient care in cardiogenic pulmonary edema.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.200120101021 |
| Uncontrolled Keywords: | Prognostic Factors, Acute Pulmonary Edema, Tertiary Care Hospital. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 02 May 2021 14:57 |
| Last Modified: | 20 Mar 2024 05:47 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15593 |
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