Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04460625 |
| Other study ID # |
2020-09 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
May 1, 2020 |
| Est. completion date |
February 7, 2022 |
Study information
| Verified date |
February 2022 |
| Source |
Zonguldak Bulent Ecevit University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
The research was planned to determine the effect of different blood groups on the 90-day
survival of intensive care patients who were treated and maintained for the first time in the
intensive care unit.
The research is a retrospective descriptive research. For the first time in an intensive care
unit aged 18 and over, between January 1, 2014 and December 31, 2019, of a state and a
university hospital in the Western Black Sea Region, in intensive care units (both medical
and surgical patients), All the patients, who were hospitalized in the intensive care unit
for at least 24 hours, were discharged from the intensive care unit for 90 days and less, and
all the information in the Patient Information Form can be accessed from the automation
system.
The research will be conducted between 01.04.2020-01.07.2020 by collecting the necessary data
within the 'Patient Information Form' of the patients from the information processing unit of
the hospitals where the research will be conducted.
Description:
Intensive care units; They are units where advanced technological tools and equipment are
used to provide the highest level of benefit to life-threatened patients, and physicians and
nurses specializing in the treatment and care of patients are involved. Intensive care
patients; '' To prevent patients who are at risk due to physiological decompensation and
patients who are physically physiologically fluctuating, need a treatment to be carried out
with the harmony between physician and nurse to ensure survival, the application of this
treatment without showing waves, especially details and care, and unexpected adverse events.
and patients who require continuous monitoring to provide immediate intervention by the
intensive care team. Intensive care patients, as can be understood from the definition, are
the patients whose general conditions change rapidly due to the presence of a
life-threatening condition, due to the impact of several systems that require close
monitoring and control vital functions.
Respiratory, cardiovascular, neurological, etc. Many conditions, such as chronic diseases,
genetic, individual and environmental factors, of patients who are in danger of life due to
many important health problems can affect the prognosis of the patients. In addition to these
factors, although there is insufficient evidence, blood groups are reported to be effective
in the survival of intensive care patients. Whatever the underlying situation is, the most
important thing is undoubtedly the blood for the maintenance of a healthy life. It is known
to affect human health in many cases, from the amount of blood circulating in the vein to the
structure of blood cells.
It was found for the first time in the years of 1899 and 1900 that human blood differs from
individual to individual due to some physiological features. These different blood groups
discovered are A, B and AB. Later, with the discovery of the Rh factor along with the O
(zero) blood group, studies on the effects and differences of blood groups on humans have
increased rapidly. Today, studies on the relationship between blood groups and diseases are
ongoing.
As a result of some studies; It has been determined that the AB blood group plays a role as a
risk factor in both venous thromboembolism and coronary artery disease. The risk of both
arterial and venous thrombotic events in the AB blood group There is evidence that it has
high levels of vonWillebrand factor (vWF) and factor VIII. Depending on the limitation of
mobilization in intensive care patients, it may increase the negative effect of the blood
group on the patient compared to the patients hospitalized in other clinics. However, in
patient groups with a high risk of bleeding, this may provide additional benefit for patients
with AB blood group with higher levels of vonWillebrand factor (vWF) and factor VIII. In
their research, Franchini et al. Reported that bleeding rate increased significantly in
patients with O blood group, especially in surgical procedures with high risk of blood loss.
Therefore, it has been observed that patients with AB blood group are more likely to survive
after major heart surgery and this situation is explained in relation to the decrease in the
number of blood transfusions. The results of metaanalysis study of Dentali et al. Also
pointed out that having an O blood group in terms of bleeding may be an important genetic
factor. It is important that the intensive care nurse includes this information in patient
care.
In a study conducted to determine the link between ABO blood group, lipid profiles and
coronary artery disease and to determine the effect size of the link, patients in the A blood
group were found to have higher total cholesterol rates while lower LDL rates. Jiang et al;
They found that ABO blood groups were not associated with age, gender, and blood pressure in
stable coronary artery patients undergoing percutaneous coronary intervention, but blood
groups were associated with 2-year cardiac death.
Although it is known that genetic diversity affecting the prognosis of patients is a factor
in determining survival after being taken into intensive care, it can be difficult and costly
to evaluate in a short time in clinical practice. Also, to predict the prognosis of critical
patients in intensive care units today. it is still very difficult. In this context,
individualized medicine; It can provide a better understanding of patients' risks arising
from genetic, environmental and social factors and better planning of the results of
treatment. At the onset of critical illness, knowing all possible risk factors to effectively
manage patients creates a chance to achieve more successful treatment and care outcomes. more
difficult to determine the effect on survival of genetic diversity, although there is nothing
for a long time consuming and costly, ABO blood group of the survival effect according to the
risk classification system, the addition of both easier, additional benefits to the patient
to be quickly and cost-free by the Ministry of Health in sağlayabilir. Türkiye APACHE II
(Acute Physiology and Chronic Health Evaluation) is the most commonly used scale to calculate
the expected mortality rate according to the severity of the disease that is approved and
admitted to intensive care.
The relationship between patients' blood groups and mortality is thought to exist as a result
of research. In the research of Slade et al; After the patients were admitted to the
intensive care unit, the relationship between blood groups and mortality was evaluated in the
90-day period; It has been determined that patients with intensive care with AB blood group
have a higher 90-day survival time compared to other blood group patients. In line with this
result, there is a need for studies for the risk assessment scales and the addition of the
blood group factor for intensive care patients.
Quality nursing care is an important factor affecting the prognosis of patients. It is
predicted that the application of individualized patient care will positively affect the
physiological, psychological and social health of the patient. Nurses are healthcare
professionals who are in key condition next to the patient in any case in intensive care
units. Higher quality care of nurses at the center of many interventions in the intensive
care unit has been associated with improved patient outcomes, including mortality. In line
with this information, the research was planned to determine the effect of different blood
groups on the 90-day survival of intensive care patients who were treated and maintained for
the first time in the intensive care unit.
