Yıl: 2011 Cilt: 22 Sayı: 3 Sayfa Aralığı: 249 - 254 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey

Öz:
Amaç: Helikobakter pilori enfeksiyonu, non-steroid antiinflamatuvar ilaçlar ve peptik ülser gastrointestinal sistem kanama nedenlerinin başında gelmektedir. Çalışmanın amacı ülkemizdeki varis dışı üst üst gastrointestinal sistem kanamalarında sosyodemografik ve etyolojik faktörlerin, tedavi özelliklerinin ve prognozun değerlendirilmesidir. Yöntem: Bu retrospektif çalış maya üst gastrointestinal sistem kanaması nedeniyle hastaneye yatırılıp üst gastrointestinal sistem endoskopisi yapılan olgular alınmıştır. Öykü, komorbidite, kullanı lan ilaçlar, yoğun bakım ünitesine yatırılma, Helikobakter pilori enfeksiyonu, kan nakilleri, üst gastrointestinal sistem endoskopisi ile uygulanan tedavilerin etkinliği retrospektif olarak değerlendirilmiştir. Bulgular: Altı merkezin 1339 hastasının verilerinden toplanan 1711 lezyon içerisinde en sık kanama yerleri (%) duodenal ülser (49.4), gastrik ülser (22.8), erozyon (9.6), kanser (2.2) olarak bulunmuştur. Helikobakter pilori varlığı 704 olguda değerlendirilerek %45.6 oranında pozitif bulunmuştur. Komorbid hastalık oranı %59.2 ve non-steroid anti-inflamatuvar ilaç ve/veya aspirin kullanımı %54.3’dür. Kanama olguların %66.9’unda medikal tedavi ile durmuştur. Olguların %3.7’sinde hasta cerrahiye verilmiş ve %1.1’i kaybedilmiştir. Sonuç: Üst gastrointestinal sistem kanaması bulunan olgular istatistiksel olarak anlamlı olacak şekilde daha yaşlı, erkek cinsiyette ve non-steroid anti-inşamatuvar ilaçlar kullanmaktadır. Olguların çoğu gastroprotektif ilaç kullanmakla birlikte, kanama nedeni olguların %70’den fazlasında duodenum veya mide ülseridir. Olguların yarısından fazlasının non-steroid anti-inşamatuvar ilaç kullanması, bu ilaçların halk sağlığı yönünden ciddi bir sorun yarattığını göstermektedir. Mortalitenin ve Helikobakter pilori varlığının anlamlı olarak düşük olması dikkat çekicidir.
Anahtar Kelime:

Konular: Cerrahi

Türkiye’de varis dışı üst gastrointestinal kanamayı gösteren retrospektif bir çalışma

Öz:
Background/aims: Helicobacter pylori infection, non-steroidal anti-inflammatory drugs and peptic ulcer are considered as the major factors for upper gastrointestinal system bleeding. The objective of the study was to determine the sociodemographic and etiologic factors, management and outcome of patients with non-variceal upper gastrointestinal system bleeding in Turkey. Methods: Patients who admitted to hospitals with upper gastrointestinal system bleeding and in whom upper gastrointestinal endoscopy was performed were enrolled in this retrospective study. The detailed data of medical history, comorbid diseases, medications, admission to intensive care units, Helicobacter pylori infection, blood transfusion, upper gastrointestinal endoscopy, and treatment outcome were documented. Results: The most frequent causes of bleeding (%) were duodenal ulcer (49.4), gastric ulcer (22.8), erosion (9.6), and cancer (2.2) among 1,711 lesions in endoscopic appearances of 1,339 patients from six centers. Seven hundred and four patients were evaluated for Helicobacter pylori infection and the test was positive in 45.6% of those patients. Comorbid diseases were present in 59.2% of the patients. The percentage of patients using acetylsalicylic acid and/or other non-steroidal anti-inflammatory drug was 54.3%. Bleeding was stopped with medical therapy in 66.9%. Only 3.7% of the patients underwent emergency surgery, and a 1.1% mortality rate was determined. Conclusions: Patients with upper gastrointestinal system bleeding were significantly older, more likely to be male, and more likely to use non-steroidal anti-inflammatory drugs. Though most of the patients were using gastro-protective agents, duodenal and gastric ulcers were the contributing factors in more than 70% of the upper gastrointestinal bleeding. The extensive use of non-steroidal anti-inflammatory drug is a hazardous health issue considering the use of these drugs in half of the patients.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. American Society for Gastrointestinal Endoscopy. The national ASGE survey on upper gastrointestinal bleeding: I. Study design and baseline data. Gastrointest Endosc 1981; 27(2): 73-9.
  • 2. Cook DJ, Guyatt GH, Salena BJ, Laine LA. Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Gastroenterology 1992; 102: 39-48.
  • 3. Gilbert DA, Silverstein FE, Tedesco FJ. The national ASGE survey on upper gastrointestinal bleeding. III. Endoscopy in upper gastrointestinal bleeding. Gastrointest Endosc 1981; 27: 94-102.
  • 4. Gilbert DA. Epidemiology of upper gastrointestinal bleeding. Gastrointest Endosc 1990; 36: S8-13.
  • 5. Rockall TA, Logan RF, Devlin HB, Northfield TC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Br Med J 1995; 311: 222- 6.
  • 6. Bobrzynski A, Beben P, Budzynski A, et al. Incidence of complications of peptic ulcers in patients with Helicobacter pylori (Hp) infection and/or NSAID use in the era of Hp eradication. Med Sci Monit 2002; 8: 554-7.
  • 7. Vakil N. H. pylori and non steroid anti-inflammatory drug. Rev Gastroenterol Disord 2003; 3: 123–4.
  • 8. Peura DA, Lanza FL, Gostout CJ, Foutch PG. The American College of Gastroenterology Bleeding Registry: preliminary findings. Am J Gastroenterol 1997; 92: 924-8.
  • 9. Morgan AG, MacAdam WA, Walmsley GL, et al. Clinical findings, early endoscopy and multivariate analysis in patients bleeding from the upper gastrointestinal tract. Br Med J 1977; 2: 237-40.
  • 10. Lau JY, Sung JJ, Lam YH, et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999; 340: 751-6.
  • 11. Vreeburg EM, Snell P, Bruijne JW, et al. Acute upper gastrointestinal bleeding in the Amsterdam area: incidence, diagnosis and clinical outcome. Am J Gastroenterol 1997; 2: 236-43.
  • 12. Katschinski B, Logan R, Davies J, et al. Prognostic factors in upper gastrointestinal bleeding. Dig Dis Sci 1994; 39: 706-12.
  • 13. Guell M, Artigau E, Esteve V, et al. Usefulness of a delayed test for the diagnosis of Helicobacter pylori infection in bleeding peptic ulcer. Aliment Pharmacol Ther 2006; 23: 53-9.
  • 14. Wolfe MM, Lichtenstein DR, Durkirpa LS. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999; 340: 1988-99.
  • 15. Zaltmani C, Souza HSP, Castro MEC, et al. Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records. Arq Gastroenterol 2002; 39: 74-80.
  • 16. Yilmaz H, Gürel S, Ozdemir O. Turkish patients with osteoarthritis: their awareness of the side effects of NSAIDs. Turk J Gastroenterol 2005; 16: 89-92.
  • 17. Garcia RLA, Jick H. Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet 1994; 343: 769-72.
  • 18. Laine L. The gastrointestinal effects of nonselective NSAIDs and COX-2-selective inhibitors. Semin Arthritis Rheum 2002; 32(3 Suppl 1): 25-32.
APA Bor S, DAĞLI Ü, ŞARER YÜREKLİ B, GÜREL S, Tozun A, SİVRİ B, Akbaş T, ŞAHİN B, MEMİK F, BATUR Y (2011). A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. , 249 - 254.
Chicago Bor Serhat,DAĞLI Ülkü,ŞARER YÜREKLİ BANU PINAR,GÜREL Selim,Tozun Ayse Nurdan,SİVRİ Bülent,Akbaş Türkay,ŞAHİN Burhan,MEMİK Faruk,BATUR Yücel A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. (2011): 249 - 254.
MLA Bor Serhat,DAĞLI Ülkü,ŞARER YÜREKLİ BANU PINAR,GÜREL Selim,Tozun Ayse Nurdan,SİVRİ Bülent,Akbaş Türkay,ŞAHİN Burhan,MEMİK Faruk,BATUR Yücel A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. , 2011, ss.249 - 254.
AMA Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. . 2011; 249 - 254.
Vancouver Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. . 2011; 249 - 254.
IEEE Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y "A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey." , ss.249 - 254, 2011.
ISNAD Bor, Serhat vd. "A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey". (2011), 249-254.
APA Bor S, DAĞLI Ü, ŞARER YÜREKLİ B, GÜREL S, Tozun A, SİVRİ B, Akbaş T, ŞAHİN B, MEMİK F, BATUR Y (2011). A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turkish Journal of Gastroenterology, 22(3), 249 - 254.
Chicago Bor Serhat,DAĞLI Ülkü,ŞARER YÜREKLİ BANU PINAR,GÜREL Selim,Tozun Ayse Nurdan,SİVRİ Bülent,Akbaş Türkay,ŞAHİN Burhan,MEMİK Faruk,BATUR Yücel A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turkish Journal of Gastroenterology 22, no.3 (2011): 249 - 254.
MLA Bor Serhat,DAĞLI Ülkü,ŞARER YÜREKLİ BANU PINAR,GÜREL Selim,Tozun Ayse Nurdan,SİVRİ Bülent,Akbaş Türkay,ŞAHİN Burhan,MEMİK Faruk,BATUR Yücel A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turkish Journal of Gastroenterology, vol.22, no.3, 2011, ss.249 - 254.
AMA Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turkish Journal of Gastroenterology. 2011; 22(3): 249 - 254.
Vancouver Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turkish Journal of Gastroenterology. 2011; 22(3): 249 - 254.
IEEE Bor S,DAĞLI Ü,ŞARER YÜREKLİ B,GÜREL S,Tozun A,SİVRİ B,Akbaş T,ŞAHİN B,MEMİK F,BATUR Y "A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey." Turkish Journal of Gastroenterology, 22, ss.249 - 254, 2011.
ISNAD Bor, Serhat vd. "A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey". Turkish Journal of Gastroenterology 22/3 (2011), 249-254.