Retrospective Evaluation of Critical Care Patients with Upper Gastrointestinal System Bleeding/Ust Gastrointestinal Sistem Kanamasi Olan Yogun Bakim Hastalarinin Retrospektif Degerlendirilmesi

• Published in: Yogu︣n bakim dergisi Vol. 10; no. 3; p. 80
• Main Authors: Kuscu, Ozlem Ozkan, Elmas, Dursun, Erdogan, Murat, Benli, Burcu Arslan, Karaogullarindan, Umit, Inal, Meltem Aktay, Destegul, Dilek, Kuran, Sedef, Karakoc, Emre
• Format: Journal Article
• Language: English
• Published: AVES 01.12.2019
• Subjects: Analysis; Comorbidity; Endoscopy; Gastrointestinal hemorrhage; Gastrointestinal system; Health aspects; Hospitals; Kidney diseases; Kidney failure; Medical research; Morbidity; Mortality; Risk factors; United Kingdom; United Kingdom
• ISSN: 1309-1689; 1309-6222
• DOI: 10.33381/dcbybd.2019.2132

Aim: Upper gastrointestinal bleeding is an important cause of mortality and morbidity. The aim of this study is to evaluate the risk factors of mortality in patients admitted to medical ICU with upper gastrointestinal bleeding. Methods: Patients admitted to medical ICU with upper GI bleeding or patients with new onset GIS bleeding during the ICU stay between January 2010-December 2016 were included. Patient datas were recorded from the hospitals database retrospectively. Results: There were 3990 patients between the study period. One hundred seventy six of these patients had gastrointestinal bleeding and enrolled the study. One hundred seventeen (66,5%) of 176 patients were male, 59 (33,5%) were female. Mean age of the patients was 63 [+ or -] 16 years. While the number of the patients who underwent endoscopy procedure was 152 (86,4%); mortality rate of these patients was 46,1%; and 91,7% for the patients who did not undergo the endoscopy procedure. Mortality rates of patients with variceal and nonvariceal bleeding diagnose were 46% and 47,6%. Uremia, renal failure, increase of the leucocyte count during the follow up, coagulopathy, increased demand of erythrocyte suspension and lack of endoscopy procedure were determined as risk factors for mortality. Conclusion: Upper gastrointestinal bleeding in the intensive care unit is a situation which is with high mortality rate. Higher APACHE II Score, presence of comorbidities are determinants of prognosis. Keywords: Upper Gastrointestinal Bleeding, Critical Patient, Stress Ulcer, Upper GIS Amac: Ust gastrointestinal sistem kanamasi onemli bir mortalite ve morbidite nedenidir. Bu calismada Cukurova Universitesi Tip Fakultesi Dahiliye Yogun Bakim Unitesinde ust gastrointestinal sistem kanamasi nedeniyle takip edilen hastalarin prognostik risk faktorlerinin incelenmesi amaclandi. Yontem: Ocak 2010-Aralik 2016 tarihleri arasinda, ust gastrointestinal sistem kanamasi tanisi ile Cukurova Universitesi Tip Fakultesi Dahiliye Yogun Bakim Unitesine yatan veya yatmakta iken ust gastrointestinal sistem kanamasi gelisen hastalar, retrospektif olarak degerlendirildi. Hastalara ait veriler, hasta dosyalari ve hastane bilgi yonetim sistemindeki kayitli epikriz ve laboratuvar sonuclarindan elde edildi. Bulgular: Calisma donemi icinde Dahiliye Yogun Bakim Unitesinde takip edilen 3990 hastanin 176'sinda ust gastrointestinal sistem kanamasi tanisi oldugu tespit edildi. Bu hastalarin 117'si (%66,5) erkek, 59'u (%33,5) kadindi. Yas ortalamasi 63 [+ or -] 16 yildi. Hastalarin Acute Physiology and Chronic Health Evaluation II Score (APACHE II skoru) ortalamasi 30 [+ or -] 9,5 idi. Yuz elli iki hastaya (%86,4) endoskopik degerlendirme yapilmisti, bunlarda mortalite orani %46,1 iken endoskopi yapilmayanlarda %91,7 idi. Varis kanamasi olanlarda mortalite orani %46 iken, non-varikoz kanamalarda ise mortalite orani % 47,6'ydi. Uremi, bobrek yetmezligi, takip sirasinda lokosit degerinin artmasi, koagulopati, eritrosit suspansiyonu transfuzyonu ihtiyacinin fazla olmasi, endoskopi yapilmamis olmasi, mortalite acisindan risk faktoru olarak belirlendi. Sonuc: Gastrointestinal Sistem Kanamasi yogun bakimlarda onemli bir morbidite ve mortalite nedenidir. APACHE II skoru, komorbid durumlarin varligi prognozu belirleyici unsurlardir. Anahtar Kelimeler: Ust Gastrointestinal Sistem Kanamasi, Kritik Hasta, Stres Ulseri, Ust GIS