Conţinutul numărului revistei |
Articolul precedent |
Articolul urmator |
196 0 |
SM ISO690:2012 ILIE, Mădălina, SANDRU, Vasile, CONSTANTINESCU, Gabriel, MACOVEI OPRESCU, Anca, NEDELCU, Cristian. Upper GI non -variceal bleeding in patients with comorbidities. In: Archives of the Balkan Medical Union Supliment, 2013, nr. S3(48), p. 66. ISSN 0041-6940. |
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Archives of the Balkan Medical Union Supliment | ||||||
Numărul S3(48) / 2013 / ISSN 0041-6940 | ||||||
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Pag. 66-66 | ||||||
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Background: Helicobacter pylori infection and administration of nonsteroidal anti-inflammatory drugs are well established risk factors for upper GI nonvariceal bleeding and despite prophylaxis measures against ulceration the incidence of GIB remains high. Other factors that must be investigated are represented by the nongastrointestinal comorbidities. Methods: We have realised a prospective study including the patients with upper GI non-variceal bleeding between january-april 2013 in Clinical Emergency Hospital Bucharest. We have used the Charlson index for staging the comorbidities and the Rockall score for determining the risk of immediate mortality. As hemostasis methods we used: Adrenalin injection and/ or sclerosant injection, electrocoagulation with monopolar probe and hemoclip placement. Results: 83 patients with upper GI non-variceal bleeding were included with the mortality at 6 months being 18%(15 patients). 86% of deceased patients had a Charlson index more than 6. 67% of the deceased patients were more than 70 years old. The risk of GIB in the presence of non-gastrointestinal comorbidities (especially cardiovascular) was much higher than administration of NSAID, antiaggregants, anticoagulants or Helicobacter pylori infection. The predicted mortality in 12 months, done at admission, on the included patients was 16,3% very well correlated with the real one of 18% done at 6 weeks from admission. Conclusions: Non-gastrointestinal comorbidities are an independent factor of GIB, neglected in favor of NSAID administration, antiaggregants and Helicobacter pylori infection. The increase of the survival age in the average population explains the increase procentage of comorbidities and the increased rate of GIB in eldery patients. The initial staging of comorbidities by Charlson index is an important predictive factor of mortality. Abbreviations: GIB-gastrointestinal bleeding, NSAID- nonsteroidal anti-inflammatory drugs. |
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Cuvinte-cheie GIB, comorbidities, Charlson index |
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