Research Article
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Acil servise dispeptik yakınmalarla müracaat eden hastaların yönetiminin değerlendirilmesi

Year 2021, , 640 - 646, 17.09.2021
https://doi.org/10.16899/jcm.913357

Abstract

Amaç: Dispepsi sindirim işleminin zorluğu anlamına gelip üst batında hissedilen şişkinlik, ağrı, yanma, erken doyma, bulantı ve geğirti semptomlarından oluşur. Dispepsi acil servislere başvurunun en önde gelen nedenlerinden bir tanesidir. Dispeptik hastaların acil serviste yönetimi hakkında halen bir uzlaşmanın olmaması nedeni ile gereğinden fazla tetkikler yapılmaktadır. Bu makalede amaç bir acil serviste dispeptik yakınma ile başvuran hastaların yönetiminde nelerin yapıldığını incelemektir.
Gereç ve Yöntem: Bu çalışma, retrospektif dosya taraması yöntemi ile yapılmış olup; 1ocak-31 aralık 2019 tarihleri arasında acil servise dispeptik yakınma nedeni ile başvuran 2798 vaka üzerinde yapılmıştır.
Bulgular: Çalışmaya dahil edilen hastaların çoğunluğu (%58,1’i) kadın olup yaş ortalaması 39.73∓17,34 yıldır. Dahil edilen hastaların %77,8 (n=2176)’i sarı alana kabul edilerek tedavi alırken tanı kodlarına göre ise de %54,8 (n=1534) oranında K29 (gastrit) tanısı konulmuştur. Hastaların %98,5’i acil servis gözleminde günübirlik tedavi alarak taburcu olurken sadece %1,5’ine hastane yatışı yapılmıştır. Dispepsi tanı kodu ile kabul edilen ve epigastrik ağrı ile başvuran 1 vaka ex olmuştur.
Sonuç: Bu çalışma ile dispeptik yakınmalı hastaların acil servise önemli oranda başvurduğu ancak hastaların %98,5 oranında ayaktan tedaviden fayda gördüğü tesbit edilmiştir. Dispeptik yakınmalı hastalardan alınacak dikkatli bir öykü ve ayrıntılı fizik muayene gereksiz tetkiklerin önlenmesi ve tedavisinde maliyet etkin davranış sergilenmesinin milli servetin korunması açısından önemli olduğu değerlendirilmektedir.

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Thanks

Dr Yasin Ergin ve Dr Ömer Jaradat'a katkılarından dolayı teşekkür ediyoruz.

References

  • Referans 1. Özden A. Dispepsi (Dyspepsia). Güncel Gastroenteroloji 2012;16:272-82.
  • Referans 2. Brun R and Kuo B. Functional dyspepsia. Ther Adv Gastroenterol 2010 may; 3(3): 145-64.
  • Referans 3. Özden A. Fonksiyoneldispepsi. Güncel Gastroenteroloji 2012;16:283-90.
  • Referans 4. Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Nimish V. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol 2017; 112:988–1013.
  • Referans 5. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015 Jul;64(7):1049-57.
  • Referans 6. Türk ÖP, Demirel ZB. The Role of Nutrition in the Management of Dyspepsia Symptoms. Bes Diy Derg 2017;45(3):258-63.
  • Referans 7. Baltacı D, Kara İH, Sönmez CI. Birinci basamakta dispepsiye yaklaşım. Turkiye Klinikleri J Fam Med-Special Topics 2015;6(4):20-7.
  • Referans 8. Pittayanon R, Leelakusolvong S, Vilaichone RK et al. Thailand Dyspepsia Guidelines: 2018. J Neuro gastroenterol Motil 2019 January; Vol. 25 No. 1: 15-26.
  • Referans 9. Ford AC, Forman D, Bailey AG, Axon ATR, Moayyedi P. Effect of dyspepsia on survival: a longitudinal 10-year follow-up study. Am J Gastroenterol 2012 Jun;107(6):912-21.
  • Referans 10. Rezailashkajani M, Roshandel D, Shafaee S, Zali MR. A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran. Dig Liver Dis 2008 Jun;40(6):412-7.
  • Referans 11. Duggan AE, Elliot CA, Miller P, Hawkey CJ, Logan RFA. Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care. Aliment Pharmacol Ther 2008;(29):55–68.
  • Referans 12. Masoumi SJ ,Mehrabani D, Moradi F, Zare N, Firouzi MS, Mazloom Z. The prevalence of dyspepsia symptoms and its correlation with the quality of life among Qashqai Turkish migrating nomads in Fars Province, Southern Iran. Pak J Med Sci 2015 Vol. 31 No. 2: 325-30.
  • Referans 13. Koduru P, Irani M, Quigley EMM, Definition, Pathogenesis and Management of that cursed Dyspepsia. Clin Gastroenterol Hepatol 2018 Apr;16(4):467-79.
  • Referans 14. Mapel D, Roberts M, Overhiser A and Mason A. The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case–Control Analysis in the Southwestern United States. Helicobacter 2013 feb;18(1): 54–65.
  • Referans 15. Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol 2006 May 7;12(17):2661-6.
  • Referans 16. Caliskan HM, Celik B, Ersoy S. Etiological evaluation of patients who present to the emergency department with dyspeptic complaints. The Turkish Journal of Academic Gastroenterology 2020;19:41-8.
  • Referans 17. Duman H. Fonksiyonel Dispepsi Etyopatogenezinde Etkili faktörlerin Hastalık Semptomları ile ilişkisini değerlendirme. İstanbul, Bakırköy Dr. Sadi Konuk Eitim ve Aratırma Hastanesi, Uzmanlık Tezi 2009.
  • Referans 18. Salihefendic N, Zildzic M, Cabric E. A New Approach to the Management of Uninvestigated Dyspepsia in Primary Care. Med Arh 2015 Apr; 69(2): 133-4.
  • Referans 19. Gisbert JP, Calvet X, Ferrándiz J et al. Clinical practice guideline on the management of patients with dyspepsia. Update 2012. Aten Primaria 2012;44(12):727.e1-727.e38.
  • Referans 20. Eliçabuk H. Dispeptik ağrı tedavisinde intravenöz esomeprazol ve ranitidinin etkinliğinin karşılaştırılması: randomize, çiftkör, kontrollü çalışma. Denizli, Pamukkale Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı,Uzmanlık Tezi 2014.
  • Referans 21. Kim SE, Kim N, Lee JY et al. Prevalence and Risk Factors of Functional Dyspepsia in Health Check-up Population: A Nationwide Multicenter Prospective Study. J Neurogastroenterol Motil 2018 Oct; 24(4): 603–13
  • Referans 22. Musikatavorn K, Tansangngam P, Lumlertgul S. A randomized controlled trial of adding intravenous pantoprazole to conventional treatment for the immediate relief of dyspeptic pain. Am J Emerg Med 2012;30(9):1737-42.

Evaluation of management of patients who apply to emergency service with dyspeptic complaints

Year 2021, , 640 - 646, 17.09.2021
https://doi.org/10.16899/jcm.913357

Abstract

Aim: Dyspepsia means difficulty in the digestive process and consists of symptoms of bloating, pain, burning, early satiety, nausea and burping. Dyspepsia is one of the leading causes for applying to emergency services. Medical workups are overdone since there is still no consensus about the management of dyspeptic patients in emergency service. The aim of this article is to evaluate what is done for the management of patients with dyspeptic complaints in the emergency service.
Materials and Methods:This study was conducted by retrospective file scanning method and consisted 2798 cases who applied to the emergency service between 1 January – 31 December 2019 with dyspeptic complaints.
Results: Most of the patients who were included in the study were female (%58,1) and the average age was 39.73∓17,34. %77,8 (n=2176) of the included patients were treated by admission to the yellow area while %54,8 (n= 1534) was diagnosed with K29 (gastritis) according to the diagnostic codes. While 98.5% of the patients were discharged with outpatient treatment in the emergency observation room, only 1.5% were hospitalized. One case admitted with dyspepsia diagnostic code and presented with epigastric pain died.
Conclusion: In this study, it was determined that patients with dyspeptic complaints present to the emergency department at a significant rate, but patients benefit from outpatient treatment at a rate of %98,5. A careful history taken from and detailed physical examination of patients with dyspeptic complaints for preventing unnecessary examinations and cost-effective behavior in the treatment are considered to be important for the preservation of national wealth.

Project Number

Proje değil

References

  • Referans 1. Özden A. Dispepsi (Dyspepsia). Güncel Gastroenteroloji 2012;16:272-82.
  • Referans 2. Brun R and Kuo B. Functional dyspepsia. Ther Adv Gastroenterol 2010 may; 3(3): 145-64.
  • Referans 3. Özden A. Fonksiyoneldispepsi. Güncel Gastroenteroloji 2012;16:283-90.
  • Referans 4. Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Nimish V. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol 2017; 112:988–1013.
  • Referans 5. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015 Jul;64(7):1049-57.
  • Referans 6. Türk ÖP, Demirel ZB. The Role of Nutrition in the Management of Dyspepsia Symptoms. Bes Diy Derg 2017;45(3):258-63.
  • Referans 7. Baltacı D, Kara İH, Sönmez CI. Birinci basamakta dispepsiye yaklaşım. Turkiye Klinikleri J Fam Med-Special Topics 2015;6(4):20-7.
  • Referans 8. Pittayanon R, Leelakusolvong S, Vilaichone RK et al. Thailand Dyspepsia Guidelines: 2018. J Neuro gastroenterol Motil 2019 January; Vol. 25 No. 1: 15-26.
  • Referans 9. Ford AC, Forman D, Bailey AG, Axon ATR, Moayyedi P. Effect of dyspepsia on survival: a longitudinal 10-year follow-up study. Am J Gastroenterol 2012 Jun;107(6):912-21.
  • Referans 10. Rezailashkajani M, Roshandel D, Shafaee S, Zali MR. A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran. Dig Liver Dis 2008 Jun;40(6):412-7.
  • Referans 11. Duggan AE, Elliot CA, Miller P, Hawkey CJ, Logan RFA. Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care. Aliment Pharmacol Ther 2008;(29):55–68.
  • Referans 12. Masoumi SJ ,Mehrabani D, Moradi F, Zare N, Firouzi MS, Mazloom Z. The prevalence of dyspepsia symptoms and its correlation with the quality of life among Qashqai Turkish migrating nomads in Fars Province, Southern Iran. Pak J Med Sci 2015 Vol. 31 No. 2: 325-30.
  • Referans 13. Koduru P, Irani M, Quigley EMM, Definition, Pathogenesis and Management of that cursed Dyspepsia. Clin Gastroenterol Hepatol 2018 Apr;16(4):467-79.
  • Referans 14. Mapel D, Roberts M, Overhiser A and Mason A. The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case–Control Analysis in the Southwestern United States. Helicobacter 2013 feb;18(1): 54–65.
  • Referans 15. Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol 2006 May 7;12(17):2661-6.
  • Referans 16. Caliskan HM, Celik B, Ersoy S. Etiological evaluation of patients who present to the emergency department with dyspeptic complaints. The Turkish Journal of Academic Gastroenterology 2020;19:41-8.
  • Referans 17. Duman H. Fonksiyonel Dispepsi Etyopatogenezinde Etkili faktörlerin Hastalık Semptomları ile ilişkisini değerlendirme. İstanbul, Bakırköy Dr. Sadi Konuk Eitim ve Aratırma Hastanesi, Uzmanlık Tezi 2009.
  • Referans 18. Salihefendic N, Zildzic M, Cabric E. A New Approach to the Management of Uninvestigated Dyspepsia in Primary Care. Med Arh 2015 Apr; 69(2): 133-4.
  • Referans 19. Gisbert JP, Calvet X, Ferrándiz J et al. Clinical practice guideline on the management of patients with dyspepsia. Update 2012. Aten Primaria 2012;44(12):727.e1-727.e38.
  • Referans 20. Eliçabuk H. Dispeptik ağrı tedavisinde intravenöz esomeprazol ve ranitidinin etkinliğinin karşılaştırılması: randomize, çiftkör, kontrollü çalışma. Denizli, Pamukkale Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı,Uzmanlık Tezi 2014.
  • Referans 21. Kim SE, Kim N, Lee JY et al. Prevalence and Risk Factors of Functional Dyspepsia in Health Check-up Population: A Nationwide Multicenter Prospective Study. J Neurogastroenterol Motil 2018 Oct; 24(4): 603–13
  • Referans 22. Musikatavorn K, Tansangngam P, Lumlertgul S. A randomized controlled trial of adding intravenous pantoprazole to conventional treatment for the immediate relief of dyspeptic pain. Am J Emerg Med 2012;30(9):1737-42.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Hacı Mehmet Çalışkan 0000-0001-7370-420X

Burak Çelik 0000-0002-6746-4083

Project Number Proje değil
Publication Date September 17, 2021
Acceptance Date June 1, 2021
Published in Issue Year 2021

Cite

AMA Çalışkan HM, Çelik B. Evaluation of management of patients who apply to emergency service with dyspeptic complaints. J Contemp Med. September 2021;11(5):640-646. doi:10.16899/jcm.913357