Gastrointestinal kanamaların mevsimsel dağılımı ve prognoz üzerine etkisinin değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Gastrointestinal sistemin herhangi bir yerinde çeşitli sebeplerle meydana gelen kanamalı tablolar gastrointestinal kanamalar olarak adlandırılır. Gastrointestinal kanamaların şiddeti spontan gerileme ile ölüm arasında geniş bir yelpazededir. Bu kanamaların hem akut tablosunda hem de hastane veya yoğun bakım yatışı döneminde yönetimi çok önemlidir. Mevsimsel değişkenlerin çeşitli patolojiler üzerinde etkisi olduğu gösterilmiştir. Gastrointestinal sistem kanamalarının sıklığı, şiddeti ve prognozu üzerinde de mevsimlerin etkisi olabileceği düşünülmektedir. Fakat mevsimlerin gastrointestinal kanamalar üzerindeki etkilerine dair çelişkili sonuçların varlığı ortak bir görüşe varılmasını engellemiştir. Bu çalışma ile mevsimlere göre gastrointestinal kanama sıklığı ve mevsimlerin prognozdaki belirleyici veya etkileyici rolünün araştırılması amaçlanmıştır. 2017 ile 2022 yılları arasında hastanemize başvuran alt veya üst gastrointestinal sistem kanaması geçiren hastaların verileri retrospektif olarak incelenmiştir. Dahil edilme kriterlerine göre örneklemimize 180 hasta alınmıştır. Gastrointestinal kanamaların %29,4 oran ile en yüksek frekansta sonbahar mevsiminde görüldüğü belirlenmiştir. Sonbahar mevsimini sırasıyla yaz, ilkbahar ve kış mevsimleri izlemiştir. Kanamaların %10,6 oran ile en yüksek frekansta mayıs ve kasım aylarında olduğu bulunmuştur. Mevsimlere göre alt ve üst gastrointestinal sistem kanamalarında yoğun bakım ihtiyacı, mortalite durumu ve kan transfüzyonu ihtiyacı şeklindeki prognostik değerlendirmeler için fark bulunmamıştır (sırasıyla p değerleri 0,299; 0,474; 0,331). Non-variseal üst gis kanamaları özelinde de aynı değişkenler için mevsimlere göre fark belirlenmemiştir (sırasıyla p değerleri 0,647; 0,552; 0,692). Hastaların mortalite durumuna göre Glasgow-Blatchford Kanama Skoru, Tam Rockall Skoru, Tekrar Kanama Riski ve Mortalite riski skorları arasında fark bulunmuştur (p<0,001). Tarafımızca bu skorlar ile mortalitenin öngörülebileceği belirlenmiştir. Gastrointestinal sistem kanaması hastalarında mevsimsel faktörlerin prognoz açısından etkileyici ve belirleyici rolü bulunmamıştır.
Hemorrhagic tables occurring in any part of the gastrointestinal system due to various reasons are called gastrointestinal bleedings. The severity of gastrointestinal bleedings ranges from spontaneous recovery to death. It is very important to manage these bleedings both in the acute presentation phase and during hospitalization or intensive care stay. It has been shown that seasonal variables have an effect on various pathologies. It is believed that seasons may also have an effect on the frequency, severity, and prognosis of gastrointestinal system bleedings. However, the existence of conflicting results regarding the effects of seasons on gastrointestinal bleeding has prevented a common view. This study aimed to investigate the frequency of gastrointestinal bleedings by seasons and the determinant or influencing role of the seasons in prognosis. The data of patients who had lower or upper gastrointestinal system bleeding and applied to our hospital between 2017 and 2022 were retrospectively examined. A sample of 180 patients was included according to the inclusion criterias. It was determined that gastrointestinal bleeding was most frequently seen in the autumn season with a rate of 29.4%. The autumn season was followed by the summer, spring, and winter seasons, respectively. It was found that bleeding was most frequent in may and november with a rate of 10.6%. There was no difference by seasons in prognostic evaluations such as intensive care need, mortality status, and need for blood transfusion in lower and upper gastrointestinal system bleedings (p-values respectively 0,299; 0,474; 0,331). Similarly, no differences were found by seasons for these variables specifically for non-variceal upper gastrointestinal bleedings (p-values respectively 0,647; 0,552; 0,692). A difference was found among the Glasgow-Blatchford bleeding score, the complete Rockall score, the risk of rebleeding, and the risk of mortality scores according to the patients' mortality status (p<0,001). It was determined by us that mortality can be predicted with these scores. Seasonal factors did not have a determinant or influencing role in prognosis of patients with gastrointestinal bleeding.
Hemorrhagic tables occurring in any part of the gastrointestinal system due to various reasons are called gastrointestinal bleedings. The severity of gastrointestinal bleedings ranges from spontaneous recovery to death. It is very important to manage these bleedings both in the acute presentation phase and during hospitalization or intensive care stay. It has been shown that seasonal variables have an effect on various pathologies. It is believed that seasons may also have an effect on the frequency, severity, and prognosis of gastrointestinal system bleedings. However, the existence of conflicting results regarding the effects of seasons on gastrointestinal bleeding has prevented a common view. This study aimed to investigate the frequency of gastrointestinal bleedings by seasons and the determinant or influencing role of the seasons in prognosis. The data of patients who had lower or upper gastrointestinal system bleeding and applied to our hospital between 2017 and 2022 were retrospectively examined. A sample of 180 patients was included according to the inclusion criterias. It was determined that gastrointestinal bleeding was most frequently seen in the autumn season with a rate of 29.4%. The autumn season was followed by the summer, spring, and winter seasons, respectively. It was found that bleeding was most frequent in may and november with a rate of 10.6%. There was no difference by seasons in prognostic evaluations such as intensive care need, mortality status, and need for blood transfusion in lower and upper gastrointestinal system bleedings (p-values respectively 0,299; 0,474; 0,331). Similarly, no differences were found by seasons for these variables specifically for non-variceal upper gastrointestinal bleedings (p-values respectively 0,647; 0,552; 0,692). A difference was found among the Glasgow-Blatchford bleeding score, the complete Rockall score, the risk of rebleeding, and the risk of mortality scores according to the patients' mortality status (p<0,001). It was determined by us that mortality can be predicted with these scores. Seasonal factors did not have a determinant or influencing role in prognosis of patients with gastrointestinal bleeding.
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
İç Hastalıkları, Internal diseases
