Acil servise başvuran üst gastrointestinal kanamalı hastalarda trombosit değerleri ile trombosit kitle indeksinin kanama şiddeti ve mortalite tahmininde değerliliğinin retrospektif olarak araştırılması
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Date
2024
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Bursa Uludağ Üniversitesi
Abstract
Amaç: Bu çalışmada acil servise üst gastrointestinal sistem (GİS) kanamasıyla başvuran hastalarda trombosit kitle indeks (PMİ) değerlerinin mortalite ile ilişkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 01.01.2019-01.01.2024 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’ne üst GİS kanama şüphesi ile başvuran 18 yaş ve üstü tüm hastalar dahil edilmiştir. Hasta verilerine retrospektif olarak hastane otomasyon sistemi üzerinden taranarak ulaşılmıştır. Üst GİS kanama nedeniyle başvuran 500 hastadan dahil edilme kriterlerine uygun 198 hasta çalışmaya alınmıştır. Tüm olguların başvuru anındaki PMİ skoru hesaplanmıştır. Bulgular: Hastaların 131’i erkek (%66,2), 67’si (33,8) kadındır. Çalışmamızdaki vakaların yaş ortalamalarının 66,02±15,62 (Min.=21,00- Maks.=96,00) olduğu görülmüştür. Hastaların 38’inin (%19,2) tilt testi sonucu pozitif saptanmış olup, 173’ünün (%87,4) Glasgow-Blatchford Skoru (GBS) 6’dan büyük tespit edilmiştir. Vakaların 18’i (%9,1) senkop, 124’ü (%62,6) melena, 93’ü (%47) hematemez nedenli başvurmuşlardır. GBS ortalamalarının mortalite gelişen hastalarda anlamlı derecede yüksek olduğu (p<0,001) saptanmıştır. PMİ medyan değerlerinin ise, istatistiksel açıdan anlamlı seviyede farklı olmadığı (p=0,103) bulunmuştur. Sonuç: Bu çalışmadaüst GİS kanamalı hastalarda PMİ değerleri ile mortalite arasında anlamlı bir ilişki gösterilememiştir. Bu konuda daha çok hastanın değerlendirildiği, çok merkezli ve prospektif çalışmalara gereksinim vardır.
Aim: We aimed to determine the correlation between platelet mass index (PMI) and mortality in patients presenting to the emergency department with upper gastrointestinal system (GIS) bleeding. Methods: The study included all patients aged 18 and over who presented to the Emergency Department of Bursa Uludağ University Medical Faculty Hospital with suspected upper gastrointestinal bleeding between January 1, 2019, and January 1, 2024. The cases were retrospectively screened through the hospital automation system. Among the 500 patients who presented with upper gastrointestinal bleeding, 198 patients who met the inclusion criteria were included in the study. The PMI score at the time of admission was calculated for all cases. Results: 131 (%66.2) of the patients were male and 67 (33.8) were female. The mean age of the cases in our study was found to be 66.02±15.62 (Min.=21.00-Max.=96.00). In 38 patients (19.2%), the tilt test result was positive, and in 173 patients (87.4%), GBS value was found to be greater than 6. It was found that 18 cases (9.1%) presented with syncope, 124 cases (62.6%) with melena, and 93 cases (47%) with hematemesis as the reasons for their visitation. It was determined that GBS averages were significantly higher in patients who developed mortality (p<.001). There was no statistically significant difference in PMI median values between groups (p=.103). Conclusion: In this study, no significant relationship was demonstrated between PMI and mortality in patients with upper gastrointestinal bleeding. However, there is a need for multi-center and prospective studies with a larger number of patients to further investigate this issue.
Aim: We aimed to determine the correlation between platelet mass index (PMI) and mortality in patients presenting to the emergency department with upper gastrointestinal system (GIS) bleeding. Methods: The study included all patients aged 18 and over who presented to the Emergency Department of Bursa Uludağ University Medical Faculty Hospital with suspected upper gastrointestinal bleeding between January 1, 2019, and January 1, 2024. The cases were retrospectively screened through the hospital automation system. Among the 500 patients who presented with upper gastrointestinal bleeding, 198 patients who met the inclusion criteria were included in the study. The PMI score at the time of admission was calculated for all cases. Results: 131 (%66.2) of the patients were male and 67 (33.8) were female. The mean age of the cases in our study was found to be 66.02±15.62 (Min.=21.00-Max.=96.00). In 38 patients (19.2%), the tilt test result was positive, and in 173 patients (87.4%), GBS value was found to be greater than 6. It was found that 18 cases (9.1%) presented with syncope, 124 cases (62.6%) with melena, and 93 cases (47%) with hematemesis as the reasons for their visitation. It was determined that GBS averages were significantly higher in patients who developed mortality (p<.001). There was no statistically significant difference in PMI median values between groups (p=.103). Conclusion: In this study, no significant relationship was demonstrated between PMI and mortality in patients with upper gastrointestinal bleeding. However, there is a need for multi-center and prospective studies with a larger number of patients to further investigate this issue.
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Keywords
Trombosit kitle indeksi, Acil servis, Üst gastrointestinal kanama, Mortalite, Platelet Mass Index (PMI), Emergency department, Upper gastrointestinal bleeding, Mortality