Nisan 2014
Varis disi akut üst gastrointestinal sistem kanamali hastalardalökositoz ile kanama ciddiyeti arasindaki iliski
The correlation between leukocytosis and the severity of bleeding in patients with acute non-variceal upper gastrointestinal system bleeding
- Ana Sayfa
- Sayılar
- Nisan 2014
- Varis disi akut üst gastrointestinal sistem kanamali hastalardalökositoz ile kanama ciddiyeti arasindaki iliski...
Özet
Giris ve Amaç: Varis disi üst gastrointestinal sistem kanamali hastalarin, hastaneye basvuru sirasinda bakilan laboratuvar parametreleri ile kanamanin ciddiyeti arasindaki iliskiyi arastiran birçok çalisma vardir. Biz de bu çalismamizda hastalarin basvuru sirasinda tespit edilen lökositozun kanama ciddiyetini gösterme açisindan prediktif degerini arastirdik. Gereç ve Yöntem:Çalismaya 2006-2010 yillari arasinda hastanemiz Haydarpasa Numune Egitim ve Arastirma Hastanesi acil poliklinigine hematemez ve/veya melena sikayeti ile basvuran, melena ve/veya hematemezi saptanip, üst gastrointestinal sistem kanama nedeniyle Iç Hastaliklari klinigine yatirilan hastalar alindi. Bu hastalarin demografik bilgileri, üst gastrointestinal sistem endoskopi bulgulari ve endoskopi sirasinda alinan biyopsilerin patoloji sonuçlari retrospektif olarak toplanarak kaydedildi. Hastalarin yalnizca acil poliklinige basvuru sirasindaki lökosit degerleri dikkate alindi. Bulgular:Gruplar arasinda lökosit sayi-lari açisindan istatistiki olarak anlamli fark saptandi (p:0,007). Gruplar arasinda platelet sayilari açisindan (p:0,039), kan üre nitrojen düzeyleri açisindan (p:0,000), albumin düzeyleri açisindan (p:0,006), eritrosit süspansiyonu replasman ihtiyaçlari açisindan (p:0,040), taze donmus plazma replasman ihtiyaçlari açisindan istatistiki olarak anlamli fark saptandi (p:0,045). Sonuç:Lökositoz ile ciddi kanama göstergeleri olan kan üre nitrojeni, eritrosit süspansiyonu ve taze donmus plazma tarnsfüzyonu ihtiyaci ve hipoalbuminemi ile yakin iliskili olmasi; lökositozun basvuru sirasinda klinik seyrin ciddiyetini öngörmeye yardimci olacak bir parametre olarak kullanilabilecegini göstermekte iken hastane yatis süreleri arasinda anlamli fark tespit edilememis olmasi hasta sayimizin kisitli olmasi ile iliskilendirilebilir. Genis hasta serilerinde yapilacak çalismalar, lökositozun üst gastrointestinal sistem kanamalarinda kullanilan klinik skorlamalarda yerini almasini saglayabilecek gibi görünmektedir
Abstract
Background and Aims:Many studies have investigated the correlation between laboratory parameters checked at presentation to the hospital and the severity of bleeding in patients with acute non-variceal upper gastrointestinal system bleeding. In this study, we investigated the predictive value of leukocytosis determined at presentation to the hospital in predicting the severity of bleeding. Materials and Methods: Patients presenting to the emergency polyclinic of Haydarpasa Numune Training and Research Hospital between 2006 and 2010 with the complaint of hematemesis and/or melena and admitted to the Internal Medicine Clinic due to upper gastrointestinal system bleeding with the detection of melena and/or hematemesis were included in the study. Collection of demographic data, upper gastrointestinal endoscopy findings, and pathological results of biopsies taken during the endoscopy was performed retrospectively. Only leukocyte values determined at presentation to the emergency polyclinic were taken into consideration.Results: Statistically significant differences were determined between the groups regarding the number of leukocytes (p: 0,007), number of platelets (p: 0,039), blood urea nitrogen levels (p: 0,000), albumin levels (p: 0,006), requirement for erythrocyte suspension replacement (p: 0,040), and requirement for fresh frozen plasma replacement (p: 0,045). Conclusions:The close association between leukocytosis and the markers of severe bleeding, such as blood urea nitrogen, requirement for erythrocyte suspension and fresh frozen plasma and hypoalbuminemia, shows that leukocytosis can be used as a parameter to help predict the severity of the clinical course at presentation to the emergency polyclinic. The inability to determine a significant difference between the hospitalization periods can be attributed to the small numbers of patients in our study. It seems that future studies performed in large patient series will facilitate leukocytosis taking its place among the clinical scoring systems used for upper gastrointestinal system bleedings.
