Acil servise başvuran gastrointestinal sistem kanamalı hastalarda kan üre azotu (BUN)
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Tarih
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Acil servise GİS kanama tanısı konan hastalarda demografik, klinik ve laboratuvar parametrelerinin, hastaların mortalite ve morbiditesi üzerinde etkili olup olmadığının araştırılması amaçlandı. Gereç ve yöntem: Çalışmamız 01.06.2018-01.06.2019 tarihleri arasında acil servise başvuran GİS kanamalı 113 olguda retrospektif olarak yapıldı. Hastaların cinsiyeti, yaşı, başvuru şikayeti, komorbid hastalıkları ve ilaç kullanımı, kanama bölgesi, laboratuar parametreleri, endoskopi bulguları, yatırıldığı birim ve mortalite durumu incelendi. Verilerin analizinde Kolmogorov-Smirnov, Mann Whitney-U, Ki-kare, Fisher Exact ve logistic regresyon analizi kullanıldı. Bulgular: Olguların yaş ortancası 67 yıl olup, %61,9'u erkekti. Hastaların %67,3'ünde ek hastalık saptandı. Alt GİS kanamalı olgularda ülseratif kolit, hemoroid ve diğer ek komorbidite varlığının sıklığı yüksek saptandı (p<0,05). Üst GİS kanamalı olgularda hematemez ve melena sıklığı anlamlı olarak yüksek iken, hematokezya alt GİS kanamalı olgularda anlamlı olarak yüksekti (p<0.05). Çalışmamızda Hb 9 gr/dl, Hct %27,5, MPV 10,4 μl, trombosit 225 x103/mm3 ortanca değerlerinde saptandı. GİS kanama seviyesi ve mortalite ile Hb, Hct, MPV ve trombosit değerleri arasında ilişki saptanmadı (p>0.05). Çalışmamızda kreatinin 0,8 mg/dl, BUN 24 mg/dl, BUN/kreatinin oranı 26 ortanca değerlerinde bulundu. GİS kanama seviyesinin kreatinin düzeyi ile arasında ilişki saptanmadı (p>0.05). Üst GİS kanamalı olgularda, BUN düzeyi ve BUN/kreatinin oranı anlamlı olarak yüksek saptandı (p<0.05). Olguların %47,8'inin servise ve %52,2'sinin yoğun bakıma yatırıldığı saptandı. Çalışmamızda mortalite oranı %4,4 düzeyinde olup, hiçbir faktörün mortaliteyi tek başına etkilemediği saptandı (p>0.05). Sonuç olarak GİS kanamalı olgularda birçok faktör hasta kliniği üzerinde etkili iken, mortaliteyi değiştirmediği saptandı. Bu durum mortal seyreden hasta sayısı ile ilişkili olabilir. Bu nedenle daha geniş vaka serilerine ihtiyaç vardır
Assessment of the relationship between specific hematological parameters versus mortality and morbidity in patients with gastrointestinal bleeding Aim: The purpose of our study was to investigate whether demographic, clinical and laboratory parameters are correlated with mortality and morbidity in patients diagnosed with (gastrointestinal) GI bleeding in the emergency department. Materials and Methods: Our study was performed retrospectively and it included 113 patients who were admitted to the emergency department with GI bleeding between 01.06.2018-01.06.2019. Patients' gender, age, complaints, comorbidities and drug use, bleeding area, laboratory parameters, endoscopy findings, hospitalization units and mortality status were investigated. Kolmogorov-Smirnov, Mann Whitney-U, Chi-square, Fisher Exact and logistic regression analysis were used for the statistical data analysis. Results: The median age of the study subjects was 67 years, with a gender representation of 61.9% male patients. Comorbidities were detected in 67.3% of the patients. The frequency of ulcerative colitis, hemorrhoids and other comorbidities was high in patients with lower GI bleeding (p<0.05). In cases with upper GI bleeding, the frequency of hematemesis and melaena is significantly high, while in the cases presenting lower GI bleeding, the frequency of hematochezia is significantly high (p<0.05). İn our study the median value registered for the blood tests as it follows: Hb 9 gr/dl, Hct %27,5, MPV 10,4 μl, trombosit 225 x103/mm3.There was no relationship between the localization of the GI bleeding and mortality and Hb, Hct, MPV or platelet values (p> 0.05). Median value found for creatinine, BUN and BUN/creatinine ratio is 0,8 mg/dl, 24 mg/dl, and respectively 26. Also, there was no relationship between Açıklamalı [i1]: Açıklamalı [i2]: The meaning of the word level in this context is similar with the word degree, as in the quantity of the bleeding which is a hard paramethers to quantify and probably it has not being done in your study. I think you wanted to say the origin of the bleeding, upper or lower GI tract, right? If I am wrong, keep the word level. GI bleeding localization and creatinine level (p> 0.05). BUN level and BUN / creatinine ratio were significantly higher in patients with upper gastrointestinal bleeding (p <0.05). Regarding hospitalization, 47.8% of the cases were followed-up in a regular hospital ward and 52.2% in intensive care unit. It was determined that the mortality rate was 4.4% and no factor was found to affect mortality alone (p> 0.05). Conclusion: We can state that although many factors in GI bleeding cases had an effect in the patient clinical aspects, it has not influenced the mortality. This might be related to the low number of patients and mortality rates registered in our study to the number of patients with mortality. Therefore, larger case series are needed.
Assessment of the relationship between specific hematological parameters versus mortality and morbidity in patients with gastrointestinal bleeding Aim: The purpose of our study was to investigate whether demographic, clinical and laboratory parameters are correlated with mortality and morbidity in patients diagnosed with (gastrointestinal) GI bleeding in the emergency department. Materials and Methods: Our study was performed retrospectively and it included 113 patients who were admitted to the emergency department with GI bleeding between 01.06.2018-01.06.2019. Patients' gender, age, complaints, comorbidities and drug use, bleeding area, laboratory parameters, endoscopy findings, hospitalization units and mortality status were investigated. Kolmogorov-Smirnov, Mann Whitney-U, Chi-square, Fisher Exact and logistic regression analysis were used for the statistical data analysis. Results: The median age of the study subjects was 67 years, with a gender representation of 61.9% male patients. Comorbidities were detected in 67.3% of the patients. The frequency of ulcerative colitis, hemorrhoids and other comorbidities was high in patients with lower GI bleeding (p<0.05). In cases with upper GI bleeding, the frequency of hematemesis and melaena is significantly high, while in the cases presenting lower GI bleeding, the frequency of hematochezia is significantly high (p<0.05). İn our study the median value registered for the blood tests as it follows: Hb 9 gr/dl, Hct %27,5, MPV 10,4 μl, trombosit 225 x103/mm3.There was no relationship between the localization of the GI bleeding and mortality and Hb, Hct, MPV or platelet values (p> 0.05). Median value found for creatinine, BUN and BUN/creatinine ratio is 0,8 mg/dl, 24 mg/dl, and respectively 26. Also, there was no relationship between Açıklamalı [i1]: Açıklamalı [i2]: The meaning of the word level in this context is similar with the word degree, as in the quantity of the bleeding which is a hard paramethers to quantify and probably it has not being done in your study. I think you wanted to say the origin of the bleeding, upper or lower GI tract, right? If I am wrong, keep the word level. GI bleeding localization and creatinine level (p> 0.05). BUN level and BUN / creatinine ratio were significantly higher in patients with upper gastrointestinal bleeding (p <0.05). Regarding hospitalization, 47.8% of the cases were followed-up in a regular hospital ward and 52.2% in intensive care unit. It was determined that the mortality rate was 4.4% and no factor was found to affect mortality alone (p> 0.05). Conclusion: We can state that although many factors in GI bleeding cases had an effect in the patient clinical aspects, it has not influenced the mortality. This might be related to the low number of patients and mortality rates registered in our study to the number of patients with mortality. Therefore, larger case series are needed.
Açıklama
Anahtar Kelimeler
İlk ve Acil Yardım, Emergency and First Aid, GİS kanama, acil servis, hematolojik parametreler, mortalite, Gastrointestinal bleeding, emergency department, hematological parameters, mortality
