Fatalna plućna tromboembolija posle produžene fizičke imobilizacije kod hospitalizovanih psihijatrijskih bolesnika
Sažetak
Uvod/Cilj. Plućna tromboembolija (PTE) može da bude jedan od uzroka iznenadne smrti kod hospitalizovanih psihijatrijskih bolesnika. Cilj našeg rada bio je da ispitamo da li fatalna PTE kod ovih bolesnika može da bude posledica njihove produžene nepokretnosti, posebno kada postoje i pridruženi faktori rizika, te da ukažemo na značaj ovog problema. Metode. Izvršena je retrospektivna analiza bolničke dokumentacije psihijatrijskih bolesnika koji su iznenada preminuli u Odeljenju za intenzivnu terapiju Klinike za psihijatriju “Dr Laza Lazarević” u Beogradu, u periodu 1. januar 2010 – 31. decembar 2011. i izdvojeni su podaci o onima za koje je autopsijom ustanovljeno da je neposredni uzrok smrti bila PTE. U njihovim istorijama bolesti analizirano je prisustvo faktora rizika od razvoja tromboze dubokih vena. Rezultati. U posmatranom periodu, od ukupno 4 001 hospitalizovanog psihijatrijskog bolesnika preminulo je 53, od kojih je za 18 tražena autopsija zbog iznedne smrti. Kod pet bolesnika autopsijski je utvrđeno da je neposredni i jedini uzrok smrti bila PTE. Svih pet bili su muškog pola, prosečne starosti 45,2 godine, i tokom hospitalizacije dobijali su snažne antipsihotike i diazepam. Od ukupnog trajanja njihove hospitalizacije (prosečno 8,2 dana), oni su bili privremeno imobilisani tokom prosečno 4,2 dana. Četvorica su imala akutnu infekciju, trojica su bili aktivni pušači, a dvojica su imali indeks telesne mase > 30 kg/m2. Zaključak. Naši rezultati ukazuju na moguću povezanost produžene fizičke imobilizacije psihijatrijskih bolesnika, koji istovremenu primaju antipsihotičnu terapiju, i fatalne PTE.
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