Üst Gastrointestinal Sistem Kanamalarında Rockall ve Blatchford Skorları ile Forrest Evrelemenin Değerlendirilmesi

Öz

Amaç: Bu çalışmada Rockall ve Blatchford skorlarının ve endoskopik Forrest evrelemesinin üst gastrointestinal sistem kanamalarında transfüzyon gereksinimi, yoğun bakım gereksinimi ön görmede etkisinin incelenmesi amaçlanmıştır. Materyal ve Metot: Bu retrospektif çalışma 1 Ocak-1 Haziran 2013 tarihleri arasında acil servise başvuran 294 gastrointestinal kanamalı hasta üzerinde yapılmıştır. Bulgular: 294 hastanın yaş ortalaması 58,73±21,30’dur. Hastaların endoskopik tanılarına bakıldığında olguların % 43,5’inde (n=128) peptik ülser, %17,3’ünde (n=51) eroziv gastrit ve %12,6’sında (n=37) eroziv bulbit olduğu görülmüştür. Forrest evrelemesi ile Rockall ve Blatchford skorları arasında istatistiksel olarak anlamlı bir ilişki bulunmamaktadır (p=0,944, p=0,757). Rockall skoru 5 ve üzerinde olanların, Blatchford skoru yüksek olanların kan transfüzyon ihtiyacı anlamlı şekilde yüksektir. (p=0,004, p=0,001). Yoğun bakıma sevk olan olguların Rockall skorlarının 5 ve üzerinde olma oranı (%61,5), taburcu olan olgulardan (%22,9) anlamlı şekilde yüksektir (p=0,003). Sonuç: Endoskopi öncesi Rockall ve Blatchford skorları ile endoskopik Forrest evrelemesi gastrointestinal kanamalı hastaların transfüzyon gereksinimi, yoğun bakım gereksinimi, mortalite riskini ön görmede, hastaların tedavi ve takibinde güvenle kullanılabilir, dolayısıyla sağlık harcamalarının azaltılmasına yardımcı olabilir.

Anahtar Kelimeler

• Blatchford skoru
• Forrest evrelemesi
• Rockall skoru
• üst gastrointestinal sistem kanaması

Evaluation of Rockall and Blatchford Scores and Forrest Staging in Upper Gastrointestinal Bleeding

Abstract

Objective: The study aimed to investigate the predictive value of Rockall and Blatchford scores and endoscopic Forrest staging in the need for transfusion and intensive care in upper gastrointestinal bleeding. Materials and Methods: This retrospective study was conducted on 294 patients with gastrointestinal bleeding who presented to the emergency department between January 1 and June 1, 2013. Results: The mean age of 294 patients was 58.73±21.30 years. The endoscopic diagnoses of the patients included peptic ulcer (43.5%, n=128), erosive gastritis (17.3%, n=51), and erosive bulbitis (12.6%, n=37). There was no statistically significant relationship between Forrest staging and Rockall and Blatchford scores (p=0.944, p=0.757). The need for blood transfusion was significantly more frequent in patients with a Rockall score of 5 and above and those with a high Blatchford score (p=0.004, p=0.001). Patients with a Rockall score of 5 and above were significantly more common among those referred to the intensive care unit (p=0.003). Conclusion: Pre-endoscopic Rockall and Blatchford scores and endoscopic Forrest staging can be used safely in predicting transfusion requirement, intensive care requirement, mortality risk, treatment and follow-up of patients with gastrointestinal bleeding, and thus may help to reduce health expenditures.

Keywords

• Blatchford score
• Forrest staging
• Rockall score
• upper gastrointestinal bleeding

Kaynakça

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