Prognostic Significance of the Hemoglobin-Albumin Ratio in Upper Gastrointestinal Bleeding

Yıl 2024, Cilt: 11 Sayı: 3, 415 - 420, 30.09.2024

Elif Tuğba Tuncel , Funda Seher Özalp Ateş

https://doi.org/10.34087/cbusbed.1476947

Öz

Öz
Amaç
Üst gastrointestinal sistem kanaması ciddi ve hayatı tehdit eden bir hastalık olup takip ve prognoz önemlidir. Bu çalışmada HAR (Hemoglobin-Albumin Oranı) skoru ile endoskopik risk skorlama sistemlerinin prognostik değeri karşılaştırıldı.
Metod
2022-2024 yılları arasında kliniğimizde üst gastrointestinal sistem kanamasıyla izlenen 153 hastanın dosyaları geriye dönük incelendi. Endoskopik risk skorlama sistemleri (Rockall skoru (RS), Glasgow-Blatchford skoru (GBS), Forrest sınıflaması hesaplandı. Kan parametrelerinden oluşan Hemoglobin-albumin oranı (HAR) skoru hesaplandı. HAR skoru, klinik bulgular ve endoskopik skorlar Mann-Whitney U Testi ve Kruskall-Wallis Testi ile karşılaştırıldı. HAR değerleri ile sayısal değişkenler arasındaki ilişkiler Spearman Korelasyon Katsayısı ile incelendi.
Bulgular
Hastaların 122’si (%79.7) erkek, 31’i (%20,3) kadındı. Endoskopik olarak en fazla duodenal ülser (% 43,7) saptandı. Ortalama GBS 10,69±3,89, RS 4,37±2,27, HAR skoru 2,88±0,64 olarak hesaplandı. HAR skoru ile Glasgow Blatchford skoru arasında düşük düzeyde anlamlı bir ilişki vardı (r= -0,254, p=0,002). Düşük hemoglobin değeri, düşük HAR skoru ve yüksek GBS’nun kötü prognozla ilişkili olduğu saptandı.
Sonuç
Üst gastrointestinal sistem kanamalı hastalarda düşük HAR skoru kötü prognozla ilişkilidir. HAR skoru endoskopik skorlama sistemlerine benzer etkili ve güvenilir belirteçlerdir. Endoskopik skorlardan yüksek GBS ile düşük HAR skorunun ilişkili olduğu saptandı. HAR skoru basit, hızlı, pratik ve daha kolay hesaplanabilir olduğundan dolayı rutin pratikte kullanılabilecektir.

Anahtar Kelimeler

Gastrointestinal sistem kanama, endoskopik skorlama sistemi, HAR, prognoz

Etik Beyan

Tüm veriler Helsinki Deklarasyonuna uygun elde edildi. Çalışmaya alınan hastalardan endoskopik işlem öncesi bilgilendirilmiş onamları alınmıştı. Celal Bayar Üniversitesi Tıp Fakültesi Sağlık Bilimleri Etik Kurulu kararı tarih: 13/03/2024 No:2286 kararı ile etik onayı alındı

Prognostic Significance of the Hemoglobin-Albumin Ratio in Upper Gastrointestinal Bleeding

Öz

ABSTRACT
Objective
Upper gastrointestinal bleeding is a serious and life-threatening condition where monitoring and prognosis are crucial. This study aimed to compare the prognostic value of the hemoglobin-albumin ratio (HAR) with endoscopic risk scoring systems.
Methods
The medical records of 153 patients with upper gastrointestinal bleeding treated at our clinic between 2022 and 2024 were retrospectively reviewed. Endoscopic risk scoring systems, including the Rockall score (RS), Glasgow-Blatchford score (GBS), and Forrest classification, were calculated. The HAR score, consisting of hematologic parameters, was computed. The HAR score was compared with clinical findings and endoscopic scores using the Mann-Whitney U and Kruskal-Wallis tests. The relationships between the HAR values and numerical variables were examined using Spearman’s correlation coefficient.
Results
Of the patients, 122 (79.7%) were male and 31 (20.3%) were female. A duodenal ulcer was the most common endoscopic finding (43.7%). The mean GBS was 10.69±3.89, RS was 4.37±2.27, and HAR was 2.88±0.64. There was a low-level significant correlation between the HAR score and the Glasgow Blatchford score (r=-0.254, p=0.002). Low hemoglobin levels, a low HAR score, and a high GBS were associated with a poor prognosis.
Conclusion
In patients with upper gastrointestinal bleeding, a low HAR score is associated with a poor prognosis. The HAR score is an effective and reliable marker, similar to endoscopic scoring systems. This study revealed a correlation between a high GBS and a low HAR score. Due to its simplicity, rapid and easy calculation, and practicality, the HAR score can be used routinely in clinical practice.

Anahtar Kelimeler

Gastrointestinal bleeding, endoscopic scoring system, HAR, prognosis

Kaynakça

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