2012 – 2017 yılları arasında Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalına başvuran üst gastrointestinal sistem kanamalı hastaların retrospektif değerlendirilmesi
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Date
2018
Authors
Sağıroğlu, Muhammed Fatih
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Üst gastrointestinal sistem (GİS) kanaması mortalite ve morbidite oranı oldukça yüksek olan acil bir durumdur. Bu çalışmada hastanemize üst GİS kanama nedeni ile başvuran hastaların demografik özellikleri, başvuru şikâyetleri, hemodinamik bulguları, komorbid hastalıklar, ilaç kullanım öyküleri, endoskopik bulgular, uygulanan tedavi yöntemleri ile ilgili güncel veri elde etmek, literatürle karşılaştırmak, hastaların mortalite ve morbiditelerini etkileyen faktörleri araştırmak amaçlanmıştır. Bu çalışma Ocak 2012-Aralık 2017 tarihleri arasında 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) olup, erkek olguların yaş aralığı 19 ile 88 arasında ve ortalama yaş 59,11 (±16,43), Kadın olgularda ise yaş aralığı 22 ile 95 arasında değişmekte ve ortalama yaş 65,82 (±17,69) idi. Hastaların %63'ü erkek %37'si kadındı. Hastaların en sık başvuru nedeni %37 ile melena olarak saptandı. Başvuru anında hastaların %6,3'ünde şok tablosu mevcuttu. Hastaların %84,3'üne eşlik eden komorbid bir hastalık vardı ve bunlar içinde en sık rastlanan hastalık %42,7 oranı ile hipertansiyon bulundu. Hastaların %51,3'ü kanamaya yatkınlık yaratan bir ve daha fazla ilaç kullanmaktaydı, bu ilaçlardan NSAİİ (nonsteroid antiinflamatuar ilaçlar) ve ASA (asetil salisilik asit) kullanımı açık ara daha fazlaydı. Hastaların %43,4'ünde peptik ülser (%24,7'sinde duodenal ülser; %18,7'sinde mide ülseri), %28'inde gastroözefagial varis, %7,7'sinde özofajit/özofagus ülseri, %9'unda gastrit (eritematöz/eroziv), %5,7'sinde malign ülser saptandı. Duodenal ülser en sık erkeklerde saptandı. Sonuç olarak çalışmamızda üst GİS kanamalarında en önemli risk faktörleri ileri yaş, cinsiyet, şok tablosu, komorbid hastalık varlığı, NSAİİ/ ASA kullanım öyküsüdür.
Upper gastrointestinal system (GIS) hemorrhage is an urgent condition with a high rate of mortality and morbidity. In this study, it was aimed to obtain updated data about the demographics, hemodynamic findings, comorbid diseases, drug use histories, endoscopic findings, applied treatment methods, compare with the literature and investigate the factors affecting the mortality and morbidity of the patients who applied to our hospital with the cause of upper GI bleeding. This study was retrospectively performed on 300 patients who were admitted to Gastroenterology Department of Uludağ University Faculty of Medicine between January 2012 and December 2017 and were diagnosed with upper gastrointestinal bleeding. Data was scanned from the hospital's archive. The mean age of the patients was 61,80 (± 17,18). The mean age of the male patients was between 19 and 88 years and the mean age was 59,11 (± 16,43). In female patients, the age range was between 22 and 95 years, 82 (± 17,69). 63% of the patients were female and 37% were male. The most common cause of the presentation was found to be melena with 37%. At the time of admission, 6,3% of the patients had a shock chart. There was a comorbid disease accompanying 84,3% of the patients and the most common disease was hypertension with a rate of 42,7%. 51,3% of patients were using one or more drugs predisposed to bleeding, the use of NSAIDs and ASAs was clearly higher among these drugs. 43,4% of patients with peptic ulcer (duodenal ulcer 24,7%, 18,7% in gastric ulcer), 28% gastroesophageal varices, 7,7% esophagitis / esophageal ulcer, 9% gastritis (erythematous / erosive), 5,7% malignant ulcer was determined. Duodenal ulcers were most commonly detected in males. In conclusion, according to our study the most important risk factors for upper GI bleeding were age, sex, presence of shock, presence of comorbid disease, NSAID / ASA usage.
Upper gastrointestinal system (GIS) hemorrhage is an urgent condition with a high rate of mortality and morbidity. In this study, it was aimed to obtain updated data about the demographics, hemodynamic findings, comorbid diseases, drug use histories, endoscopic findings, applied treatment methods, compare with the literature and investigate the factors affecting the mortality and morbidity of the patients who applied to our hospital with the cause of upper GI bleeding. This study was retrospectively performed on 300 patients who were admitted to Gastroenterology Department of Uludağ University Faculty of Medicine between January 2012 and December 2017 and were diagnosed with upper gastrointestinal bleeding. Data was scanned from the hospital's archive. The mean age of the patients was 61,80 (± 17,18). The mean age of the male patients was between 19 and 88 years and the mean age was 59,11 (± 16,43). In female patients, the age range was between 22 and 95 years, 82 (± 17,69). 63% of the patients were female and 37% were male. The most common cause of the presentation was found to be melena with 37%. At the time of admission, 6,3% of the patients had a shock chart. There was a comorbid disease accompanying 84,3% of the patients and the most common disease was hypertension with a rate of 42,7%. 51,3% of patients were using one or more drugs predisposed to bleeding, the use of NSAIDs and ASAs was clearly higher among these drugs. 43,4% of patients with peptic ulcer (duodenal ulcer 24,7%, 18,7% in gastric ulcer), 28% gastroesophageal varices, 7,7% esophagitis / esophageal ulcer, 9% gastritis (erythematous / erosive), 5,7% malignant ulcer was determined. Duodenal ulcers were most commonly detected in males. In conclusion, according to our study the most important risk factors for upper GI bleeding were age, sex, presence of shock, presence of comorbid disease, NSAID / ASA usage.
Description
Keywords
Üst gastrointestinal sistem kanaması, Endoskopi, Mortalite, Upper gastrointestinal system bleeding, Endoscopy, Mortality
Citation
Sağıroğlu M. F. (2018). 2012 – 2017 yılları arasında Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalına başvuran üst gastrointestinal sistem kanamalı hastaların retrospektif değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.