Kıvanç KARAMAN, Şerafettin ENHOŞ, Alten OSKAY, Hamit Hakan ARMAĞAN

ERİTROSİT DAĞILIM HACMİ ACİL SERVİSTE BURUN KANAMASININ CİDDİYETİNİ ÖN GÖREBİLİR Mİ?

Amaç Bu çalışmada burun kanaması için risk faktörlerinin sıklıkları ortaya konulmaya çalışılırken aynı zamanda bu risk faktörlerinin acil serviste burun kanaması yönetimi üzerine etkisi olup olmadığı sorgulandı.Gereç ve Yöntem Erişkin acil servisde 01/01/2017-01/01/2018 tarihleri arasında burun kanaması (R04.0) tanı kodu girilen hastaların dosyaları tarandı ve hastaların isim, yaş, cinsiyet, başvuru tarihi, tıbbi özgeçmiş, kullandığı ilaç, vital bulguları, konsultasyon bilgileri ve laboratuar bulguları kaydedildi. Travma, 18 yaş altı ve kanama bozukluğuna yol açan sistemik hastalığı olan hastalar çalışma dışı bırakıldı. Konsultasyon istenen hastalar ciddi burun kanaması olarak değerlendirildi.Bulgular Çalışmaya 68 erkek, 40 kadın olmak üzere toplam 108 hasta dahil edildi. Elli yaş üzeri hasta oranının %70.4 olduğu görüldü. En sık başvurunun sırasıyla %30.6 ve %29.6 ile kış ve ilkbahar aylarında olduğu görüldü. Hipertansiyon sıklığı %46.3, ilaca bağlı kanama sıklığı %31.5 saptandı. Konsultasyon istenme oranının %19.4 olduğu görüldü. Konsultasyon istenen ve istenmeyen hastaların birbiri ile karşılaştırılması sonucunda erkek cinsiyet ve yüksek Eritrosit Dağılım Genişliği (RDW) açısından anlamlı farklılık saptandı (P değerleri sırasıyla 0.016 ve 0.029).Sonuç Acil servise başvuran burun kanamalı hastalarda yüksek RDW ve erkek cinsiyet kanamanın ciddiyetini gösteren parametreler olarak ortaya çıkmaktadır. Acil serviste burun kanamalı hasta yaklaşımında bu parametreler de göz önünde bulundurulmalıdır.

CAN RED CELL DISTRUBITION WIDTH PREDICT SEVERITY OF EPISTHAXIS IN EMERGENCY DEPARTMENT?

Objective In this study, the frequency of risk factors for ephistaxis was tried to be revealed, and at the same time, it was questioned whether these risk factors had an effect on emergency ephistaxis management. Material and Methods Patients with ephistaxis diagnostic code were scanned in the adult emergency department between 01/01/2017-01/01/2018 and the patient’s name, age, sex, date of application, medical history, medication, vital findings, consultation information and laboratory findings were recorded. Trauma patients, patients under the age of 18 and patients with systemic disease leading to bleeding disorder were excluded from the study. Patients requiring consultation were evaluated as severe ephistaxis. Results A total of 108 patients, 68 male and 40 female, were included in the study. It was seen that 70.4% of the patients were over 50 years old. The most frequent application was seen in winter and spring with 30.6% and 29.6%, respectively. The frequency of hypertension and bleeding due to drugs were 46.3% and 31.5%, respectively. It was seen that the rate of consultation was 19.4%. There was a significant difference in terms of male sex and elevated red cell distrubition width (RDW) as a result of comparison between con sulted patients and non-consulted patients (P values are 0.016 and 0.029 respectively). Conclusion Elevated RDW and male sex appear as parameters determining the severity of ephistaxis in emergency department. These parameters should also be taken into consideration in the approach of ephistaxis patients in emergency department.

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