GASTROİNTESTİNAL ANJİYODİSPLAZİLİ HASTALARDA KANAMAYI ETKİLEYEN KLİNİK ÖZELLİKLER VE RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Öz

AMAÇ: Bu çalışmanın amacı, anjiyodisplazili hastalarda kanamayı etkileyen klinik özellikleri ve risk faktörlerini değerlendirmektir. GEREÇ VE YÖNTEM: Bu retrospektif çalışma Ocak 2016 ile Aralık 2019 tarihleri arasında yapılmış olup, iki kurumda herhangi bir nedenle endoskopi/kolonoskopi tetkiki yapılan hastalar dahil edilmiştir. Anjiyodisplazili hastalar kanama durumlarına göre iki gruba ayrılarak klinik özellikleri ve kanamayı etkileyen risk faktörleri incelendi. BULGULAR: Endoskopi ve kolonoskopi yapılan 44 (%2,02) hastada anjiyodisplazi tespit edildi. Anjiyodisplazili hastaların %25'inde (n=11) kanama tespit edildi. Kanamalı anjiyodisplazi hastalarında varfarin kullanım sıklığı (p=0,016) ve kalp hastalığı sıklığı (p=0,008) daha yüksekti. Kanamalı anjiyodisplazi hastalarında hemoglobin (p=0,001), hematokrit (p < 0,001), trombosit düzeyleri (p=0,009) ve toplam demir bağlama kapasitesi (p=0,036) anlamlı olarak daha düşük bulundu. Varfarin kullanan hastaların, kullanmayanlara göre 12.917 kat daha yüksek kanama riskine sahip olduğu bulundu (OR:12,917, %95 GA: 2,014-82,830, p=0,007). Kanama yaş (p=0,196), cinsiyet (p=0,326), lezyon sayısı (p=0,063), mide lezyonu (p=0,880), duodenum lezyonu (p=0,472), kolon lezyonu (p=0,947), lezyon boyutu (p=0,789), nonsteroid antiinflamatuar ilaç kullanımı (p=0,631), hipertansiyon (p=0,163), siroz (p=0,179), koroner arter hastalığı (p=0,448) ve kalp hastalıkları (p=0.207) ile ilişkili değildi. SONUÇ: Varfarin kullanımı gastrointestinal anjiyodisplazili hastalarda kanama riskini artırmaktadır. Gastrointestinal anjiyodisplazili hastalarda kanamayı etkileyen risk faktörlerinin kapsamlı prospektif çalışmalarla değerlendirilmesi gerekmektedir.

Anahtar Kelimeler

• Arteriovenöz Malformasyonlar
• Anjiyodisplazi
• Endoskopi
• Kolonoskopi
• Gastrointestinal Kanama
• Risk Faktörleri

EVALUATION OF CLINICAL FEATURES AND RISK FACTORS AFFECTING BLEEDING IN PATIENTS WITH GASTROINTESTINAL ANGIODYSPLASIA

Öz

AIM: The aim of the study was to evaluate the clinical features and risk factors affecting bleeding in patients with angiodysplasia. MATERIA L AND METHOD: This retrospective study was conducted between January 2016 and December 2019, and included patients who underwent endoscopy/colonoscopy examination for any reason at two institutions (n=2177). Patients with angiodysplasia were divided into two groups according to their bleeding status, and their clinical features and risk factors affecting bleeding were analyzed. RESULTS: Angiodysplasia was detected in 44 (2.02%) patients who underwent endoscopy and colonoscopy. Bleeding was detected in 25% (n=11) of patients with angiodysplasia. Warfarin use frequency (p=0.016) and heart disease frequency (p=0.008) were higher in patients with angiodysplasia with bleeding. Hemoglobin (p=0.001), hematocrit (p < 0.001), platelet levels (p=0.009) and total iron binding capacity (p=0.036) were found to be significantly lower in patients with bleeding angiodysplasia. It was found that patients using warfarin had a 12.917-fold higher risk of bleeding than nonusers (OR:12.917, 95%CI: 2.014-82.830, p=0.007). Bleeding was not associated with age (p=0.196), gender (p=0.326), number of lesions (p=0.063), gastric lesion (p=0.880), duodenal lesion (p=0.472), colonic lesion (p=0.947), size of lesion (p=0.789), nonsteroidal anti-inflammatory drugs use (p=0.631), hypertension (p=0.163), cirrhosis (p=0.179), coronary artery disease (p=0.448) and heart diseases (p=0.207). CONCLUSION: The use of warfarin increases the risk of bleeding in patients with gastrointestinal angiodysplasia. Risk factors affecting bleeding in patients with gastrointestinal angiodysplasia need to be evaluated in comprehensive prospective studies.

Anahtar Kelimeler

• Arteriovenous Malformations
• Angiodysplasia
• Endoscopy
• Colonoscopy
• Gastrointestinal Hemorrhage
• Risk Factors

Kaynakça

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