Araştırma Makalesi
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Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding

Yıl 2022, Cilt 21, Sayı 1, 8 - 14, 26.04.2022
https://doi.org/10.17941/agd.1105381

Öz

Background and Aims: Acute gastrointestinal system hemorrhages are frequent, and anemia is frequently seen in patients with acute gastrointestinal system bleeding after hospital discharge. Studies intended for patient follow-ups after discharge and anemia treatment are limited, and this topic has no guidelines. This study aimed to evaluate anemia prevalence and clinical approach in patients with acute gastrointestinal system bleeding after hospital discharge and during 3 months of follow-up. Materials and Method: This study retrospectively evaluated 197 patients with acute gastrointestinal system bleeding who were treated at our hospital between January 2017 and May 2018. Upon discharge, anemia was accepted as hemoglobin levels of < 13 g/dL in men and 12 g/dL in women according to the World Health Organization criteria. Results: Of these patients, 129 underwent upper gastrointestinal endoscopy; 3 enteroscopy; 45 lower gastrointestinal endoscopy; 8 upper and lower gastrointestinal endoscopy; 2 upper, middle, and lower gastrointestinal endoscopies; and 10 did not undergo endoscopy. Additionally, 69 patients underwent therapeutic endoscopic treatments. The mean hospitalization duration was 10 ± 13.84 days, and 67% of patients had erythrocyte transfusion with a mean value of 3.5 ± 5.89 units during hospitalization. The mean hemoglobin rate was 9.85 ± 1.67 g/dL upon hospital discharge. Of the patients, 92.4% (female: 91.1%, male: 93.2%; upper gastrointestinal bleeding: 93.9%, middle gastrointestinal bleeding: 100%, lower gastrointestinal bleeding: 86.8%) had anemia upon hospital discharge and 9.7% underwent iron deficiency treatment. Of all 197 patients, 33% were evaluated 3 months after discharge from the hospital and 80% of these patients have ongoing anemia. Conclusions: Anemia frequency is high when patients with acute gastrointestinal system bleeding are discharged. Most patients are discharged without receiving a prescription for anemia. In the follow-up, control applications are inadequate and anemia persists in patients. A wider range of patient studies on the treatment application and adherence, as well as guidelines from the consensus body on this issue, is necessary.

Kaynakça

  • 1. Hwang JH, Fisher DA, Ben-Menachem T, et al; Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc 2012;75:1132-8.
  • 2. ASGE Standards of Practice Committee; Gurudu SR, Bruining DH, Acosta RD, et al. The role of endoscopy in the management of suspected small-bowel bleeding. Gastrointest Endosc 2017;85:22-31.
  • 3. ASGE Standards of Practice Committee; Pasha SF, Shergill A, Acosta RD, et al. The role of endoscopy in the patient with lower GI bleeing. Gastrointest Endosc 2014;79:875-85.
  • 4. Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015;47:a1-46.
  • 5. Akpınar H, Çetiner M, Keshav S, Örmeci N, Törüner M. Diagnosis and treatment of iron deficiency anemia in patients with inflammatory bowel disease and gastrointestinal bleeding: iron deficiency anemia working group consensus report. Turk J Gastroenterol 2017;28:81-7.
  • 6. Gordon S, Bensen S, Smith R. Long-term follow-up of older patients with iron deficiency anemia after a negative GI evaluation. Am J Gastroenterol. 1996; 91:885-9.
  • 7. Rockey DC, Cello JP. Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med 1993; 329:1691-5.
  • 8. Sahay R, Scott BB. Iron deficiency anaemia- how far to investigate? Gut 1993; 34:1427-8.
  • 9. Schilling D, Grieger G, Weidmann E, et al. Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract. Z Gastroenterol 2000;38:827-31.
  • 10. Bager P, Dahlerup JF. Lack of follow-up of anaemia after discharge from an upper gastrointestinal bleeding centre. Dan Med J 2013;60:A4583.
  • 11. Bager P, Dahlerup JF. Randomised clinical trial: oral vs. intravenous iron after upper gastrointestinal haemorrhage--a placebo-controlled study. Aliment Pharmacol Ther 2014;39:176-87.
  • 12. WHO/UNICEF/UNU. Iron deficiency anemia: assessment, prevention and control. Report of a joint WHO/UNICEF/UNU consultation. Geneva: World Health Organization, 1998.

Gastrointestinal kanamayla taburcu olan hastalarda anemi prevalansı ve klinik yaklaşım

Yıl 2022, Cilt 21, Sayı 1, 8 - 14, 26.04.2022
https://doi.org/10.17941/agd.1105381

Öz

Giriş ve Amaç: Akut gastrointestinal sistem kanamaları sıktır. Bu hastaların taburculukları sırasında anemi sıklıkla gözlenmektedir. Bu hastaların hem taburculuk sonrası izlemi hem de anemi tedavilerine yönelik çalışmalar kısıtlıdır ve bu konu ile ilgili kılavuzlar bulunmamaktadır. Bu çalışmada akut gastrointestinal sistem kanaması geçiren hastalarda taburcu olurken ve takip eden 3 aylık süreçte anemi prevalansı ve anemiye yaklaşım değerlendirilmiştir. Gereç ve Yöntem: Hastanemize Ocak 2017 – Mayıs 2018 tarihleri arasında akut gastrointestinal sistem kanamasıyla yatan 197 hasta retrospektif olarak değerlendirilmiştir. Taburculuk sırasında anemi, Dünya Sağlık Örgütü kriterlerine göre, hemoglobin değerinin erkeklerde 13 g/dL, kadınlarda ise 12 g/dL’nin altında olması olarak kabul edilmiştir. Bulgular: Akut gastrointestinal sistem kanama nedeniyle hastaneye yatan hastaların 129’una üst gastrointestinal sistem endoskopi, 3’üne enteroskopi, 45’ine alt gastrointestinal sistem endoskopi, 8’ine üst ve alt gastrointestinal sistem endoskopi, 2’sine üst, orta ve alt gastrointestinal sistem endoskopi uygulanmış, 10 hastaya işlem uygulanamamıştır. Hastaların 69’una endoskopik terapötik girişim yapılmıştır. Hastaların hastanede kalış süresi; 10 ± 13.84 gün iken, yatış sırasında hastaların %67’sine, ortalama 3.5 ± 5.89 ünite eritrosit süspansiyonu transfüze edilmiştir. Hastaların taburculuk sırasındaki ortalama hemoglobin değeri 9.85 ± 1.67 g/dL’dir. Hastaların %92.4’ünde (kadın %91.1, erkek %93.2, üst gastrointestinal sistem kanama %93.9, orta gastrointestinal sistem kanama %100, alt gastrointestinal sistem kanama %86.8) taburculuk sırasında anemi saptanmıştır. Anemi saptanan hastaların %9.7’sine taburculuk sırasında demir tedavisi reçete edilmiştir. 197 hastanın %33 kadarı taburculuk sonrası ilk üç ay içerisinde tekrar değerlendirilmiş ve bunların da %80’inde halen aneminin devam ettiği saptanmıştır. Sonuç: Akut gastrointestinal sistem kanamalı hastalar taburcu edilirken anemi oranı yüksektir. Çoğu hasta anemiye yönelik bir reçete almadan taburcu olmaktadır. İzlemde kontrol başvuruları yetersiz olup, hastalarda anemi devam etmektedir. Bu konuda uygulanacak tedavi ve takibin nasıl olması gerektiğiyle ilgili daha geniş sayılı hasta çalışmalarına ve bu konuda görüş birliğinin sağlandığı kılavuzlara ihtiyaç vardır.

Kaynakça

  • 1. Hwang JH, Fisher DA, Ben-Menachem T, et al; Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc 2012;75:1132-8.
  • 2. ASGE Standards of Practice Committee; Gurudu SR, Bruining DH, Acosta RD, et al. The role of endoscopy in the management of suspected small-bowel bleeding. Gastrointest Endosc 2017;85:22-31.
  • 3. ASGE Standards of Practice Committee; Pasha SF, Shergill A, Acosta RD, et al. The role of endoscopy in the patient with lower GI bleeing. Gastrointest Endosc 2014;79:875-85.
  • 4. Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015;47:a1-46.
  • 5. Akpınar H, Çetiner M, Keshav S, Örmeci N, Törüner M. Diagnosis and treatment of iron deficiency anemia in patients with inflammatory bowel disease and gastrointestinal bleeding: iron deficiency anemia working group consensus report. Turk J Gastroenterol 2017;28:81-7.
  • 6. Gordon S, Bensen S, Smith R. Long-term follow-up of older patients with iron deficiency anemia after a negative GI evaluation. Am J Gastroenterol. 1996; 91:885-9.
  • 7. Rockey DC, Cello JP. Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med 1993; 329:1691-5.
  • 8. Sahay R, Scott BB. Iron deficiency anaemia- how far to investigate? Gut 1993; 34:1427-8.
  • 9. Schilling D, Grieger G, Weidmann E, et al. Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract. Z Gastroenterol 2000;38:827-31.
  • 10. Bager P, Dahlerup JF. Lack of follow-up of anaemia after discharge from an upper gastrointestinal bleeding centre. Dan Med J 2013;60:A4583.
  • 11. Bager P, Dahlerup JF. Randomised clinical trial: oral vs. intravenous iron after upper gastrointestinal haemorrhage--a placebo-controlled study. Aliment Pharmacol Ther 2014;39:176-87.
  • 12. WHO/UNICEF/UNU. Iron deficiency anemia: assessment, prevention and control. Report of a joint WHO/UNICEF/UNU consultation. Geneva: World Health Organization, 1998.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Makaleler
Yazarlar

Seda BAYRAK DURMAZ Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, İzmir, Turkey
0000-0001-8272-5686
Türkiye


Göksel BENGİ Bu kişi benim (Sorumlu Yazar)
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0002-7859-4094
Türkiye


Hatice KEYVAN Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, İzmir, Turkey
0000-0002-7032-6124
Türkiye


Mesut AKARSU Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0001-9217-948X
Türkiye


Müjde SOYTÜRK Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0002-2646-639X
Türkiye


Ender ELLİDOKUZ Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0001-5863-3298
Türkiye


Ömer TOPALAK Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0003-2699-021X
Türkiye


Hale AKPINAR Bu kişi benim
Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, İzmir, Turkey
0000-0002-8734-2518
Türkiye

Yayımlanma Tarihi 26 Nisan 2022
Yayınlandığı Sayı Yıl 2022, Cilt 21, Sayı 1

Kaynak Göster

Bibtex @araştırma makalesi { agd1105381, journal = {Akademik Gastroenteroloji Dergisi}, issn = {1303-6629}, eissn = {2149-0600}, address = {}, publisher = {Türk Gastroenteroloji Vakfı}, year = {2022}, volume = {21}, number = {1}, pages = {8 - 14}, doi = {10.17941/agd.1105381}, title = {Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding}, key = {cite}, author = {Bayrak Durmaz, Seda and Bengi, Göksel and Keyvan, Hatice and Akarsu, Mesut and Soytürk, Müjde and Ellidokuz, Ender and Topalak, Ömer and Akpınar, Hale} }
APA Bayrak Durmaz, S. , Bengi, G. , Keyvan, H. , Akarsu, M. , Soytürk, M. , Ellidokuz, E. , Topalak, Ö. & Akpınar, H. (2022). Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding . Akademik Gastroenteroloji Dergisi , 21 (1) , 8-14 . DOI: 10.17941/agd.1105381
MLA Bayrak Durmaz, S. , Bengi, G. , Keyvan, H. , Akarsu, M. , Soytürk, M. , Ellidokuz, E. , Topalak, Ö. , Akpınar, H. "Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding" . Akademik Gastroenteroloji Dergisi 21 (2022 ): 8-14 <https://dergipark.org.tr/tr/pub/agd/issue/69579/1105381>
Chicago Bayrak Durmaz, S. , Bengi, G. , Keyvan, H. , Akarsu, M. , Soytürk, M. , Ellidokuz, E. , Topalak, Ö. , Akpınar, H. "Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding". Akademik Gastroenteroloji Dergisi 21 (2022 ): 8-14
RIS TY - JOUR T1 - Gastrointestinal kanamayla taburcu olan hastalarda anemi prevalansı ve klinik yaklaşım AU - SedaBayrak Durmaz, GökselBengi, HaticeKeyvan, MesutAkarsu, MüjdeSoytürk, EnderEllidokuz, ÖmerTopalak, HaleAkpınar Y1 - 2022 PY - 2022 N1 - doi: 10.17941/agd.1105381 DO - 10.17941/agd.1105381 T2 - Akademik Gastroenteroloji Dergisi JF - Journal JO - JOR SP - 8 EP - 14 VL - 21 IS - 1 SN - 1303-6629-2149-0600 M3 - doi: 10.17941/agd.1105381 UR - https://doi.org/10.17941/agd.1105381 Y2 - 2021 ER -
EndNote %0 Akademik Gastroenteroloji Dergisi Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding %A Seda Bayrak Durmaz , Göksel Bengi , Hatice Keyvan , Mesut Akarsu , Müjde Soytürk , Ender Ellidokuz , Ömer Topalak , Hale Akpınar %T Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding %D 2022 %J Akademik Gastroenteroloji Dergisi %P 1303-6629-2149-0600 %V 21 %N 1 %R doi: 10.17941/agd.1105381 %U 10.17941/agd.1105381
ISNAD Bayrak Durmaz, Seda , Bengi, Göksel , Keyvan, Hatice , Akarsu, Mesut , Soytürk, Müjde , Ellidokuz, Ender , Topalak, Ömer , Akpınar, Hale . "Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding". Akademik Gastroenteroloji Dergisi 21 / 1 (Nisan 2022): 8-14 . https://doi.org/10.17941/agd.1105381
AMA Bayrak Durmaz S. , Bengi G. , Keyvan H. , Akarsu M. , Soytürk M. , Ellidokuz E. , Topalak Ö. , Akpınar H. Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding. Akademik Gastroenteroloji Dergisi. 2022; 21(1): 8-14.
Vancouver Bayrak Durmaz S. , Bengi G. , Keyvan H. , Akarsu M. , Soytürk M. , Ellidokuz E. , Topalak Ö. , Akpınar H. Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding. Akademik Gastroenteroloji Dergisi. 2022; 21(1): 8-14.
IEEE S. Bayrak Durmaz , G. Bengi , H. Keyvan , M. Akarsu , M. Soytürk , E. Ellidokuz , Ö. Topalak ve H. Akpınar , "Prevalence of anemia and clinical approach in patients discharged after gastrointestinal bleeding", Akademik Gastroenteroloji Dergisi, c. 21, sayı. 1, ss. 8-14, Nis. 2022, doi:10.17941/agd.1105381

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