Retrospective Evaluation of Acute Upper Gastrointestinal System Bleeding Patients Admitted to Gastroenterology Clinic

Öz

Upper gastrointestinal system (GIS) bleeding is an emergency with a high mortality and morbidity rate. In this study, it was aimed to obtain current data on demographic features, clinical findings, application complaints, hemodynamic findings, comorbid diseases, drug use histories, endoscopic findings, ES replacement numbers, hospitalization days of patients admitted to our hospital with upper GIS bleeding. This study was performed retrospectively on 300 patients who were admitted to Bursa Uludağ University Faculty of Medicine Gastroenterology Department between January 2012 and December 2017 and diagnosed with upper GIS bleeding. Patients' files were scanned from the hospital archive. The mean age of the patients was 61.80 (± 17.18). 63% of the patients were male, and 37% were female. The most common reason for admission was melena, with 37%. There was a comorbid disease accompanying 84.3% of the patients. The most common comorbid disease was hypertension, with 42.7%. 51.3% of the patients were using one or more drugs that were prone to bleeding, and nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA) were found to be significantly higher. Peptic ulcer in 43.4% of patients (duodenal ulcer in 24.7%; gastric ulcer in 18.7%), gastroesophageal varicose veins bleeding in 28%, gastritis (erythematous / erosive) in 9%, Esophagitis / esophageal ulcer in 7.7% and 5.7% had malignant ulcer-mass. Duodenal ulcer was most common in men. As a result, acute upper GIS bleeding is one of the most important emergency application reasons, and it can be fatal if not intervened in time despite the technological developments. In our study, peptic ulcer bleeding was found to be the most common cause of upper GIS bleeding. Especially, advanced age, male gender, ASA, and NSAID use were detected as an increased risk factor in upper GI bleeding.

Anahtar Kelimeler

• Upper gastrointestinal system bleeding
• etiology
• peptıc ulcer
• endoscopy
• varicose veins bleeding

Gastroenteroloji Kliniğine Başvuran Akut Üst Gastrointestinal Sistem Kanamalı Hastaların Retrospektif Değerlendirilmesi

Öz

Üst gastrointestinal sistem (GİS) kanaması mortalite ve morbidite oranı oldukça yüksek olan acil bir durumdur. Bu çalışmamızda hastanemize üst GİS kanaması ile başvuran hastaların demografik özellikleri, klinik bulguları, başvuru şikayetleri, hemodinamik bulguları, komorbid hastalıkları, ilaç kullanım öyküleri, endoskopik bulguları, eritrosit süspansiyon (ES) replasman sayıları, yatış günleri ile ilgili güncel veri elde etmek ve literatürle karşılaştırmak amaçlanmıştır. Bu çalışma Ocak 2012-Aralık 2017 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji Bölümüne başvuran endoskopi yapılan ve üst GİS kanama tanısı konulan 300 hasta üzerinde retrospektif olarak yapıldı. Hastaların dosyaları hastane arşivinden tarandı. Hastaların yaş ortalaması 61,80±17,18 olarak saptandı. Hastaların %63’ü erkek %37’si kadındı. Hastaların en sık başvuru nedeni %37 ile melena olarak saptandı. Hastaların %84,3’üne eşlik eden komorbid bir hastalık vardı. En sık komorbid hastalık %42,7 ile hipertansiyondu. Hastaların %51,3’ü kanamaya yatkınlık yaratan bir ve daha fazla ilaç kullanmaktaydı, bu ilaçlardan nonsteroid antiinflamatuar ilaçlar (NSAİİ) ve asetil salisilik asit (ASA) kullanımı belirgin şekilde fazla olduğu saptandı. Hastaların %43,4’ünde peptik ülser (%24,7’sinde duodenal ülser; %18,7’sinde mide ülseri), %28’inde gastroözofagial varis kanaması, %9’unda gastrit (eritematöz/eroziv), %7,7’sinde özofajit/özofagus ülseri, %5,7’sinde malign ülser-kitle saptandı. Duodenal ülser erkeklerde daha sık saptandı. Sonuç olarak çalışmamızda üst GİS kanamasının en sık nedeni olarak peptik ülser kanaması saptandı. Özellikle ileri yaş, erkek cinsiyet, ASA ve NSAİİ kullanımı üst GİS kanamasında artmış bir risk faktörü olarak saptandı.

Anahtar Kelimeler

• Üst gastrointestinal sistem kanaması
• etiyoloji
• peptik ülser
• endoskopi
• varis kanaması

Kaynakça

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