Altay KANDEMİR, Mehmet SÜLE, İrfan YAVAŞOĞLU, Mevlüt TÜRE, Adil COŞKUN, Abdülvahit YÜKSELEN, M. Hadi YAŞA

Nonvarisial Üst Gastrointestinal Sistem Kanamalarında Klinik Gidiş ve Nötrofil-Lenfosit Oranı ve Lökosit Sayısı Arasındaki İlişkinin Değerlendirilmesi

Amaç: Nonvariseal üst gastrointestinal sistem kanamaları (NVUGIB) kanamaları yaşamı tehdit eden ve mortalite oluşturan kanamalardır. NVUGIB’li hastalarda prognoz ve mortalite için risk faktörlerini belirlemek önemlidir. Biz bu çalışmada, NVUGIB li hastalarda, lökositoz ve nötrofil-lenfosit oranının hastalığın klinik seyiri ile ilişkisini değerlendirdik. Gereç-Yöntemler: Kliniğimizde, Eylül 2013 – Mart 2017 tarihleri arasında NVUGIB tanısı konulan 156 hasta çalışmaya alındı. Hastaların demografik verileri, endoskopik bulguları, eritrosit süspansiyonu ihtiyacı, hastanede yatış süresi, yoğun bakım ihtiyacı, cerrahi müdahaleye ihtiyaç, ölüm ile lökosit sayısı ve nötrofil-lenfosit oranı (NLR) ilişkisi araştırılmıştır. Results: Hastaların 103’ü (%66,7) erkek, 52’si (%33,3) kadın, yaş ortalamaları 63,8 ± 17,6 saptandı. Endoskopi bulgularına göre kanamanın en sık nedeni peptik ülserdir (%77,6). Hem lökosit sayısı hem de NLR ile yoğun bakım ihtiyacı, cerrahi müdahaleye ihtiyaç ve tedavi sonucu arasında istatistiksel olarak anlamlı bir ilişki bulunmadı. Ancak Hastaların NLR’a göre hastanede yatış süre ortalaması arasında istatistiksel olarak anlamlı bir ilişki vardı (p:0,02) Sonuç: NVUGIB sahip hastaların hastaneye başvurusu sırasında saptanan bulguları ve laboratuvar verileri çerçevesinde önceden değerlendirebilmek hastanın takibine, tedavi planlamasına olumlu katkı yapmaktadır. Lökosit tek başına ya da diğer klinik ve laboratuar parametrelerle kombine edilerek, akut olarak hastaneye yatırılan hastalarda mortalite potansiyelinin ölçülmesinde önemli bir marker olabilir. Çalışmamızda NLR ile hastanede yatış süre ortalaması ile anlamlı ilişki saptanmış olup, hastalığın prognozu ile ilişkisini gösteren daha ileri çalışmalar yapmak için teşvik edici olmalıdır.

Anahtar Kelimeler:

Nonvarisial üst gastrointestinal sistem kanaması, lökositoz, nötrofil-lenfosit oranı

Assessment of the Relationship Between Leukocyte Count and Neutrophil-to-Lymphocyte Ratio and Clinical Course in Non-Variceal Upper Gastrointestinal System Bleeding

Objective: Nonvariceal upper gastrointestinal system bleeding (NVUGIB) is a life-threatening condition that can lead to mortality. It is important to identify the risk factors in terms of prognosis and mortality in patients with NVUGIB. In this study, we assessed the relationship between leukocytosis and neutrophil-to-lymphocyte ratio and the clinical course in patients with NVUGIB.Materials and Methods: We included 156 patients who were diagnosed with NVUGIB between September 2013 and March 2017 in our clinic. The relationship between demographic data, endoscopic findings, need for erythrocyte suspension, length of hospital stay, need for intensive care, need for surgical intervention and mortality of the patients with the number of leukocytes and neutrophil-to-lymphocyte ratio (NLR) was investigated.Results: Of the patients, 104 (66,7%) were male, 52 (33,3%) were female, and mean age was 63,8±17,6 years. According to endoscopic findings, the most common cause of the bleeding was peptic ulcer (77,6%). There was no statistically significant correlation between leukocyte count and NLR and need for intensive care, need for surgical intervention and treatment outcome. However, there was a statistically significant relationship between NLR and length of hospital stay (p=0,02) Conclusions: Evaluation of the patients with NVUGIB timely through their findings detected at admission and their laboratory results would make a positive contribution to treatment planning and follow up of the patient. Leukocyte count alone or in combination with other clinical and laboratory parameters can be a valuable marker in measuring mortality potential of acutely hospitalized patients. In our study, we found a significant relationship between NLR and the average length of hospital stay, which should be encouraged for further studies investigating its relation with the prognosis of the disease.

Keywords:

Nonvariceal upper gastrointestinal bleeding, leukocytosis, neutrophil-to-lymphocyte ratio,

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