Kaan CELİK, Beliz ÖZTOK TEKTEN, Tamer ÇOLAK, Gülsüm KAVALCI, Cemil KAVALCI

Serum Laktat Akut Üst Gastrointestinal Sistem Kanamalı Hastalarda 30 Günlük Mortaliteyi Belirlemede Belirteç Olabilir

Amaç: Üst gastrointestinal sistem kanamalı (GİSK) hastalarda serum laktat düzeyinin 30 günlük mortaliteyi öngörmedeki yerini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya 377 üst GİSK’lı hasta dahil edildi. Hastaların yaş, cinsiyet, semptom ve bulgular, komorbidite ve ilaçlar, hemoglobin, verilen eritrosit miktarı, laktat düzeyi, mortalite oranları kaydedildi. Hastalar GIS kanama sonrası ölen ve yaşayanlar olarak 2 gruba ayrıldı. Grupların klinik ve laboratuar değişkenleri karşılaştırıldı. Grupların karşılaştırılmasında Ki-kare testi ve Mann-Witney U testi kullanıldı. 30 günlük mortaliteyi belirlemede serum laktat düzeyinin sensitivite ve spesifitesini belirlemek için ROC eğrisi çizdirildi. P<0,05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Eksitus olan 42 hastanın (%11.1) laktat düzeyi ortancası 3 mmol/L (QR:3.3 mmol/L), yaşayan hastaların laktat düzeyi ortancası 1.7 mmol/L (QR:1.3 mmol/L) olduğu saptandı. Eksitus olan hastaların laktat düzeyi anlamlı olarak yüksek saptandı (p<0.001). 30 günlük Mortaliteyi belirlemede serum laktatın sensitivite ve spesifitesini belirlemek için ROC eğrisi çizdirildi. 3 mmol/L için; sensitivite %79.5 ve spesifite 53.8 olarak saptandı Sonuç: Serum Laktat düzeyi yüksek olan hastaların daha mortal seyrettiğini tespit edildi.

Anahtar Kelimeler:

Üst gastrointestinal kanama, Lactate, Mortalite

Serum Lactate may be a Marker for Determining 30-Day Mortality in Patients with Acute Upper Gastrointestinal System Bleeding

Ojective: We aimed to examine the role of serum lactate level in predicting 30-day mortality in patients with upper gastrointestinal bleeding (GIB). Matarial and Method: 377 upper GIB cases included in the study. Age, gender, symptoms and signs, comorbidity and drugs, hemoglobin, amount of red blood cells administered, lactate level, mortality rates were recorded. The patients were divided into 2 groups as those who died and those who survived after GI bleeding. The clinical and laboratory variables of the groups were compared. Chi-square test and Mann-Witney U test were used to compare the groups. The ROC curve was plotted to determine the sensitivity and specificity of serum lactate level in determining 30-day mortality. A p value of <0.05 was considered statistically significant. Results: The median lactate level of 42 (11.1%) deceased patients was 3 mmol/L (QR: 3.3 mmol/L), and the median lactate level of the surviving patients was 1.7 mmol/L (QR: 1.3 mmol/L). The lactate level of the patients who died was found to be significantly higher (p<0.001). The ROC curve was plotted to determine the sensitivity and specificity of serum lactate in determining 30-day Mortality. for 3 mmol/L; sensitivity was 79.5% and specificity was 53.8%. Conclusion: It was determined that patients with high serum lactate levels were more mortal.

Keywords:

Upper gastrointestinal bleeding, Lactate, Mortality,

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