Üst gastrointestinal sistem kanaması ile başvuran hastalarda başvuru laktat düzeyi ve nötrofil-lenfosit oranının mortalite ile ilişkisi

Giriş ve Amaç: Akut üst gastrointestinal sistem kanaması ile başvuran hastalarda, başvuru anında hastalık ciddiyetini belirlemek ve uygun müdahalelerde bulunmak prognoz açısından oldukça önemlidir. Bu sebeple birçok prognostik skorlama sistemi geliştirilmiştir. Bu çalışmadaki amacımız klinik kullanımı oldukça kolay olan başvuru laktat düzeyinin hastane içi mortaliteyi öngörme yeteneğini değerlendirmek ve mortalite ile ilişkili diğer parametreleri araştırmaktır. Gereç ve Yöntem: Çalışma Mart 2020 - Mart 2023 arasında üst gastrointestinal sistem kanaması ile başvuran 154 hasta dahil edilerek retrospektif olarak gerçekleştirilmiştir. Hastaların klinik, demografik ve laboratuvar bulguları değerlendirilerek hastane içi ölüm için bağımsız prediktörler belirlendi ve bu prediktörlerin tahmin yetenekleri incelendi. Bulgular: Toplam 154 hastanın 99'u (%64.3) erkek, 55'i (%35.7) kadındı. Çalışma popülasyonunun ortalama yaşı 67.2 ± 17.8 idi. Hastane içi mortalite 19 (%12.3) hastada gelişti. Başvurudaki nötrofil-lenfosit oranı (OR: 1.149, %95 GA:1.077 - 1.226), albümin (OR: 0.089, %95 GA: 0.021 - 0.367) ve laktat (OR: 1.202, %95 GA: 1.031 - 1.402) çok değişkenli regresyon analizinde hastane içi ölüm için bağımsız prediktörler olarak saptandı. ROC analizinde nötrofil-lenfosit oranı, albümin ve laktat kombinasyonunun hastane içi ölüm için eğri altındaki alan değeri 0.974 (%95 GA: 0.950 - 0.998) olarak bulundu. Sonuç: Başvuru laktat, nötrofil-lenfosit oranı ve albümin düzeyi hastane içi mortaliteyi predikte eden bağımsız risk faktörleri olarak bulundu.

Anahtar Kelimeler:

Gastrointestinal sistem kanaması, laktat, mortalite, nötrofil-lenfosit oranı

Association between admission lactate level and neutrophil-lymphocyte ratio with mortality in patients presenting with upper gastrointestinal bleeding

Background and Aims: In patients presenting with acute upper gastrointestinal bleeding, determining the severity of the disease at the time of admission and making appropriate interventions is very important in terms of prognosis. For this reason, many prognostic scoring systems have been developed. Our aim in this study is to evaluate the ability of admission lactate level to predict in-hospital mortality and to investigate other mortality-related factors. Materials and Methods: The study was conducted retrospectively, including 154 patients admitted with upper gastrointestinal bleeding between March 2020 and March 2023. By evaluating the clinical, demographic and laboratory findings of the patients, independent predictors of in-hospital death were determined and the predictive abilities of these predictors were examined. Results: Of the 154 patients, 99 (64.3%) were male and 55 (35.7%) were female. The mean age of the study population was 67.2 ± 17.8 years. In-hospital mortality occurred in 19 (12.3%) patients. The neutrophil to lymphocyte ratio (OR: 1.149, %95 CI: 1.077 - 1.226), albumin (OR: 0.089, %95 CI: 0.021 - 0.367), and lactate OR: 1.202, %95 CI: 1.031 - 1.402) at admission were determined as independent predictors for in-hospital death. In ROC analysis, the area under the curve for in-hospital death for the combination of albumin, neutrophil-lymphocyte ratio and lactate was 0.974 (%95 CI: 0.950 - 0.998). Conclusion: Admission lactate, neutrophil-lymphocyte ratio and albumin levels were found to be independent risk factors predicting in-hospital mortality.

Keywords:

Gastrointestinal bleeding, lactate, mortality, neutrophil-lymphocyte ratio,

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