VARİS DIŞI ÜST GASTROİNTESTİNAL SİSTEM KANAMALI HASTALARDA HEMOGRAM PARAMETRELERİ VE VİTAL BULGULARIN GERİYE DÖNÜK İNCELENMESİ.

Objective Bleeding originating from proximal to the ligament of Treitz is referred to as upper gastrointestinal tract (GI) bleeding. Upper GI bleeding is an important cause of morbidity and mortality and should be excluded in patients presenting with blood in the mouth, black stools or blood in the stool. Diagnosis of upper GI bleeding, prediction of prognosis and mortality, and early intervention are crucial in emergency departments. In this study, we aimed to determine the prognostic value of hemogram parameters, vital values and risk scores in patients hospitalized with upper GI bleeding from emergency department. Material and Method In this study, 259 patients aged 18 years and older who were admitted to Süleyman Demirel University Faculty of Medicine Emergency Department between January 2015 and January 2020 for upper GI bleeding were retrospectively evaluated. Vital signs, hemogram parameters such as hemoglobin, hematocrit, red cell distribution width (RDW), white blood cell (WBC), platelet, vital values and risk scores (Glasgow-Blacthford and AIMS65) at admission were recorded from hospital records. Then survival status was also investigated. Patients who were pregnant, had malignancy, hematologic disease, history of esophageal varices, patients who were discharged directly from the emergency department, patients who were referred, patients who left the emergency department by signing a refusal of treatment or without permission, and patients whose file data could not be accessed were not included in the study. Results A total of 259 patients (157 females, 102 males, mean age: 72.7±17 years) with non-variceal upper GI bleeding were included in the study. Patients who died had significantly higher age, shock index, pulse rate, neutrophil/lymphocyte ratio, RDW, GlasgowBlatchford and AIMS65 scores (p:0.009; p<0.001; p:0.004; p:0.013; p:0.001; p<0.001; p<0.001; respectively) and lower mean arterial pressure (p:0.006). As a result of the ROC analysis, it was observed that AIMS65 score above the threshold of 2 had the highest sensitivity (82.5%) and RDW above the threshold of 16.5 had the highest specificity (62.6%) in predicting mortality in patients with upper GI bleeding. Conclusion Evaluation of vital values, shock index, neutrophil/ lymphocyte ratio, RDW, AIMS65 and GlasgowBlatchford score in patients with upper GI bleeding admitted to the emergency department contributes to the emergency physician to predict prognosis, need for early treatment and mortality. WBC and platelet indices are thought to have no effect in predicting prognosis and mortality. [ABSTRACT FROM AUTHOR]