Prognostic Value of Increased Blood Ammonia Levels in Emergency Department

Abstract

%42'si (n=37) kadın, %58'i (n=51) erkek idi. Ortalama yaş 61. 42±15.69 yıl idi. Olguların %70.5'inde (n=62) siroz, %23.9'unda (n=21) karaciğerde malignite ve %26.1'inde (n=23) diğer kronik hastalıklar olduğu tespit edildi. Hastaların ortalama kan şekeri düzeyi 153,84±118.44 mg/dl, ortalama amonyak (NH3) düzeyi 194.19±113.42 idi. Hastaların %37.5'i (n=33) taburcu, %54.5'i (n=48) yatış ve %8'inin (n=7) öldüğü tespit edildi. Hastaların ortalama kan amonyak değerini 194,19±113,42 olarak saptadık, %61.4'ünün (n=54) altı ay içinde mortalite ile sonuçlanırken, %38.6'sında (n=34) altı ay içinde mortalite gelişmediğini gözlemledik. Sonuç: Acil seviste artmış kan amonyak düzeyinin primer ya da metastatik karaciğer malignitesi olan hastalar dışında prognostik değerliliğinin olmadığını düşünmekteyiz.ABSTRACT Introduction: An increase in blood ammonia levels, is a condition that occurs in patients with impaired liver function. In this study we aimed to investigate whether there is a relationship between increased ammonia levels and prognosis in these patients. Methods: In this study, patients with incresed ammonia level who applied emergency clinic of Health Science University Kanuni Sultan Suleyman Research and Training Hospital between 01.01.2016 and 01.01.2017 researched retrospectively. NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used for statistical analysis. Significance was assessed at p<0.05. Results: 88 patients were scanned in this study, %42 (n=37) of them were female and %58(n=51) of them were male. The mean age was determined as 61.42±15.69. Cirrhosis was observed in 70.5% (n=62) of the cases, malignancy findings in the liver in 23.9% (n=21) and other chronic diseases in 26.1% (n=23) were observed. The mean blood sugar level was 153,84±118.44 mg/dl and the mean blood ammonia level of these cases was 194.19±113.42. It was observed that 37.5% (n=33) of the cases were discharged, 54.5% (n=48) of them was hospitalized and 8% (n=7) of them did die. The mean blood ammonia value of the patients was found to be 194.19 ± 113.42, 61.4% (n=54) resulted in mortality within six months, and 38.6% (n 34) had no mortality within six months. Conclusion: We think that increased blood ammonia levels can not be use as a prognostic value in emergency department, except patients with primary or metastatic liver malignancies.