Andreja Sinkovič (Author)

Abstract

Izhodišča. Dejavniki umrljivosti akutne težke krvavitve iz zgornjega dela prebavne cevi so visoka starost, spremljajoče bolezni in endoskopski dokaz aktivne krvavitve. Naš cilj je prikaz neodvisnih dejavnikov bolnišnične umrljivosti pri naših bolnikih s težko akutno krvavitvijo iz zgornje prebavne cevi. Metode. Retrospektivno smo pregledali popise 54 bolnikov, sprejetih zaradi akutne krvavitve iz zgornjega dela prebavil, dokazano endoskopsko in/ali s hipotenzijo in/ali tahikardijo. Dejavniki umrljivosti so bili testirani z univariantno in multivariantno statistično metodo. Rezultati. Najpogostejši vzrok krvavitve so bile varice in erozije, nato peptična razjeda. Umrljivost naših bolnikov je bila 31,5 %. Med umrljimi in preživelimiso bile statistično pomembne razlike v prisotnosti hemoragičnega šoka (82,4 % vs. 27 %, p<0,001), odpovedi srca (76,5 % vs. 18,9 %, p<0,001), okužbi (47 % vs. 10,8 %, p=0,005), sprejemnem diastoličnem krvnem tlaku (55,4 +/- 22 mm Hg vs. 69,7 +/- 17,7 mmHg, p=0,016), sprejemnem hemoglobinu (74,2 +/- 25,7 g/L vs. 94,2 +/- 22,2 g/L, p=0,005) in eritrocitih (2,4 +/-0,7 10, 10 [na] 12/L vs. 3 +/- 0,7 10.10 [na] 12 /L, p=0,005, v najnižjem hemoglobinu (65,8 +/- 24,3 g/L vs. 80 +/- 18,3 g/L, p=0,02) in eritrocitih (2 +/- 0,7 10.10 [na] 12/L vs.2,5 +/- 0,6 10.10 [na] 12/L, p=0,007) med zdravljenjem. Glede na logistično regresijo je najpomembnejši neodvisni dejavnik umrljivosti naših bolnikov odpoved srca in ožilja, nato najnižji hemoglobin in eritrociti med zdravljenjem. Zaključki. Krvavitve iz varic so bile najpogostejši vzrok akutne krvavitve iz zgornjih prebavil. Najpomembnejši neodvisni dejavnik bolnišnične umrljivosti, ki je bila 31.5 %, je bolezen srca in ožilja.

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Language: Slovenian
Year of publishing:
Typology: 1.04 - Professional Article
Organization: UM - University of Maribor
UDC: 616.34-005
COBISS: 2487103 Link will open in a new window
ISSN: 1318-0347
Parent publication: Zdravniški vestnik
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Secondary language: English
Secondary title: Predictive factors of in-hospital mortality in patients with acute severe upper gastrointestinal bleeding
Secondary abstract: Background. Older age, comorbidities and endoscopic stigmata of active bleeding are predictive factors of mortality in patients with acute upper gastrontestinal hemorrhage. Our aim was to assess independent predictors of in-hospital mortality of our patients with acute severe upper gastrointestinal bleeding. Methods. We reviewed retrospectively charts of 54 patients admitted to ICU due to acute upper gastrointestinal bleeding as demonstrated endoscopically and/or with hypotension and/or tachicardia. Predictors of mortality were tested by univariate and multivariate statistical methods. Results. Most frequent causes of bleeding were varices, followed by erosions and peptic ulcers. Mortality of our patients was 31.5 %. Between non-survivors and survivors statistically significant differences were observed in hemorhagic shock (82.4 % vs. 27 %, p < 0.001), heart failure (76.5 % vs. 18.9 %, p < 0.001), infection (47 % vs. 10.8 %, p=0.005), admission diastolic blood pressure (55.4 +/- 22 mm Hg vs. 69.7 +/- 17.7 mmHg, p=0.016), admission hemoglobin (74.2 +/- 25.7 g/L vs. 94.2 +/- 22.2 g/L, p=0.005), erythrocytes (2.4 +/- 0.7 10.10 [sup] 12/L vs. 3 +/- 0.7 10.10 [sup] 12/L, p=0.005), lowest hemoglobin (65.8 +/- 24.3 g/L vs. 80 +/- 18.3 g/L, p=0.02) and erythrocytes (2 +/- 0.7 10.10 [sup] 12/L vs. 2.5 +/- 0.6 10.10 [sup] 12/L, p=0.007) during treatment. According to logistic regression the heart failure, followed by the lowest hemoglobin and erythrocytes were most significant independent predictors of mortality of our patients. Conclusions. Variceal bleeding was most frequent cause of upper gastrointestinal hemorrhage. Heart failure was most significant independent predictor of in-hospital mortality, being 31.5 %.
Secondary keywords: Upper Gastrointestinal Tract;Zgornja prebavna cev;Hemorrhage;Krvavitev;Hospital Mortality;Bolnišnična umrljivost;
URN: URN:NBN:SI
Type (COBISS): Not categorized
Pages: str. II-63 - II-68
Volume: ǂLetn. ǂ75
Issue: ǂsupl. ǂII
Chronology: 2006
ID: 9094185