Research Article
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Acil Servisine Akut Üst Gastrointestinal Sistem Kanaması ile Başvuran Hastaların Analizi
Abstract
Özet
Amaç: Gastrointestinal sistem kanamaları acil serviste sıkça karşılaşılan ve hayatı tehdit etme potansiyeli yüksek olan bir sağlık sorunudur. Acil servisimize başvuran ve üst gastrointestinal sistem kanama tanısı alan hastalardaki etiyolojik sebepleri, klinik bulguları, endoskopik bulguları ve prognozu belirlemek için bu çalışmayı planladık.
Gereç ve Yöntemler: Üst gastrointestinal sistem kanaması nedeniyle acil servise başvuran hastaların dosyaları retrospektif olarak incelendi. Çalışmaya alınan 31 hastanın demografik verileri, klinik özellikleri, etiyolojik sebepleri, laboratuvar ve endoskopi sonuçları incelendi. İstatistiksel değerlendirmede Student t ve Oneway ANOVA testi ve SPSS 20.0 paket programı kullanıldı. İstatistiksel olarak p<0.05 anlamlı kabul edildi.
Bulgular: Hastaların en sık başvuru sebebi hematemezdi. Hastalara yapılan endoskopi işlemi sonucunda en sık eroziv gastrit saptandı. Tedavi olarak %16.1 oranında hastaya skleroterapi, diğer hastalara da medikal tedavi uygulanmıştı. Hastaların %83.9’u taburcu olmuş, %16.1’i ise exitus olmuştu.
Sonuç: Non-steroid anti-inflamatuar grubu analjezikler ve antiagregan grubu ilaçlar üst gastrointestinal sistem kanamasında önemli rol oynamaktadır. Özellikle ek hastalık öyküsü olan yaşlı popülasyonun ilaç kullanımı dikkatli sorgulanmalı ve analjezikler reçete edilirken gastrointestinal sistem kanama olasılığı unutulmamalıdır. Mortalite üst gastrointestinal sistem kanamalı hastalarda yüksektir. Tedaviye hızla başlanmalı ve endoskopi en kısa sürede planlanmalıdır.
Keywords
References
- Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 2016. p. 297-334.
- Blok BK, Cheung DS, Platts-Mills TF. First Aid for the Emergency Medicine Boards Third Edition: McGraw Hill Professional; 2016.
- Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: A population-based study. Am J Gastroenterol 1997; 92:419–424.
- Van Leerdam ME, Vreeburg EM, Rauws EA, Geraedts AAM, Tijssen JGP, Reitsma JB et al. Acute upper GI bleeding. Did anything change? Am J Gastroenterol 2003; 98:1494–1499.
- Adams A, Meltzer AC. How can I tell if my patient has a gastrointestinal bleed? Is it an upper gastrointestinal bleed (UGIB) or lower gastrointestinal bleed (LGIB)? Gastrointestinal Emergencies: Springer; 2019:35-37.
- Cappell MS, Friedel D. Initial management of acute upper gastrointestinal bleeding: From initial evaluation up to gastrointestinal endoscopy. Med Clin North Am 2008;92:491-509.
- Süleyman T., Abdülkadir G., Mustafa Y. Karadeniz Teknik Üniversitesi Tıp Fakültesi Acil Servisine başvuran üst gastrointestinal sistem kanamalı hastaların etyolojik ve prognostik değerlendirilmesi. Turk J Emerg Med 2010;10(1):20-25.
- Gündüz A, Kesen J, Topbaş M, Arslan M, Narci H, Yandi M. Acil servise başvuran üst gastrointestinal sistem kanamalı olguların retrospektif analizi. Turkish J Med 2004;2:57-61
- Rockall TA, Logan RF, Devlin HB, Northfield TC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 1995;311(6999):222-226.
- Sereda S, Lamont I, Hunt P. The experience of a haematemesis and melaena unit: A review of the first 513 consecutive admissions. Med J Aust 1977;1(11):362-366.
- Thomopoulos KC, Mimidis KP, Theocharis GJ, Gatopoulou AG, Kartalis GN, Nikolopoulou VN. Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome. World J Gastroenterol 2005;11(9):1365-1368.
- Rockall TA, Logan RF, Devlin HB, Northfield TC. Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage. Gut 1997;41(5):606-611.
- Lau JY, Sung JJ, Lam YH, Chan AC, Ng EK, Lee DW et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999;340(10):751-756.
- Göksu E, Erken Ö, Erçetin Y, Kılıçaslan İ, Çete Y. Akdeniz Üniversitesi Hastanesi Acil Servisine üst gastrointestinal sistem kanaması ile başvuran hastalarda mortaliteyi belirleyen faktörler ve demografik özellikleri. Türkiye Acil Tıp Dergisi. Eylül 2004;4(3):121-126.
Analysis of Patients With Acute Upper Gastrointestinal System Hemorrhage Applying to Kahramanmaras Sutcu Imam University Medical Faculty Emergency Department
Abstract
Abstract
Objective: Gastrointestinal system bleeding is a health problem with a high life-threatening potential that is frequently encountered in emergency departments in hospitals. This study was planned to determine the etiologic causes, clinical findings, endoscopic findings, and prognosis in patients admitted to our emergency department and diagnosed with upper gastrointestinal system bleeding.
Material and Methods: The files of the patients admitted to emergency department due to upper gastrointestinal system bleeding were retrospectively reviewed. Demographic data, clinical characteristics, etiological causes, laboratory and endoscopic results of 31 patients were reviewed. In statistical evaluation, Student t test, One way ANOVA test and SPSS 20.0 package program was used. p<0.05 was considered statistically significant.
Results: Hematemesis was the most common reason for admission. As a result of the endoscopic procedure performed on the patients, erosive gastritis was found most frequently. 16.1% of the patients underwent sclerotherapy, and other patients underwent medical treatment. 83.9% of the patients were discharged, however, 16.1% of them died.
Conclusion: Analgesics of the non-steroidal anti-inflammatory drugs group and the drugs of the antiaggregant group play a significant role in upper gastrointestinal system bleeding. The drug use should be carefully investigated especially in the elderly population with a history of comorbidities, and the possibility of gastrointestinal system bleeding should not be forgotten while prescribing analgesics. Mortality is high in patients with upper gastrointestinal system bleeding, the treatment should be initiated quickly, and endoscopy should be planned as soon as possible.
References
- Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 2016. p. 297-334.
- Blok BK, Cheung DS, Platts-Mills TF. First Aid for the Emergency Medicine Boards Third Edition: McGraw Hill Professional; 2016.
- Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: A population-based study. Am J Gastroenterol 1997; 92:419–424.
- Van Leerdam ME, Vreeburg EM, Rauws EA, Geraedts AAM, Tijssen JGP, Reitsma JB et al. Acute upper GI bleeding. Did anything change? Am J Gastroenterol 2003; 98:1494–1499.
- Adams A, Meltzer AC. How can I tell if my patient has a gastrointestinal bleed? Is it an upper gastrointestinal bleed (UGIB) or lower gastrointestinal bleed (LGIB)? Gastrointestinal Emergencies: Springer; 2019:35-37.
- Cappell MS, Friedel D. Initial management of acute upper gastrointestinal bleeding: From initial evaluation up to gastrointestinal endoscopy. Med Clin North Am 2008;92:491-509.
- Süleyman T., Abdülkadir G., Mustafa Y. Karadeniz Teknik Üniversitesi Tıp Fakültesi Acil Servisine başvuran üst gastrointestinal sistem kanamalı hastaların etyolojik ve prognostik değerlendirilmesi. Turk J Emerg Med 2010;10(1):20-25.
- Gündüz A, Kesen J, Topbaş M, Arslan M, Narci H, Yandi M. Acil servise başvuran üst gastrointestinal sistem kanamalı olguların retrospektif analizi. Turkish J Med 2004;2:57-61
- Rockall TA, Logan RF, Devlin HB, Northfield TC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 1995;311(6999):222-226.
- Sereda S, Lamont I, Hunt P. The experience of a haematemesis and melaena unit: A review of the first 513 consecutive admissions. Med J Aust 1977;1(11):362-366.
- Thomopoulos KC, Mimidis KP, Theocharis GJ, Gatopoulou AG, Kartalis GN, Nikolopoulou VN. Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome. World J Gastroenterol 2005;11(9):1365-1368.
- Rockall TA, Logan RF, Devlin HB, Northfield TC. Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage. Gut 1997;41(5):606-611.
- Lau JY, Sung JJ, Lam YH, Chan AC, Ng EK, Lee DW et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999;340(10):751-756.
- Göksu E, Erken Ö, Erçetin Y, Kılıçaslan İ, Çete Y. Akdeniz Üniversitesi Hastanesi Acil Servisine üst gastrointestinal sistem kanaması ile başvuran hastalarda mortaliteyi belirleyen faktörler ve demografik özellikleri. Türkiye Acil Tıp Dergisi. Eylül 2004;4(3):121-126.
There are 14 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Early Pub Date | November 1, 2022 |
| Publication Date | November 2, 2022 |
| Submission Date | October 20, 2021 |
| Acceptance Date | November 25, 2021 |
| Published in Issue | Year 2022 Volume: 17 Issue: 3 |
