Özofageal varis kanamalı olgularda mortaliteye etki eden risk faktörleri
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Özofageal Varis kanamaları (OVK), portal hipertansiyon zemininde gelişen ve hastane
yatışı esnasında yüksek mortalite riski nedeni ile gelişen önemli bir komplikasyondur.
Çalışmamızda sirotik OVK nedeni ile Necmettin Erbakan Üniversitesi Tıp Fakültesi
hastanesine başvurarak takip ve tedavi edilen hastaların demografik özellikleri, klinik ve
laboratuvar incelemeleri, görüntüleme ve endoskopik incelemeleri, mortalite ve
komplikasyonların gelişimi incelenmiş ayrıca bu sonuçların literatür verileri ile kıyaslanması
amaçlanmıştır. Olguların mortaliteye etki edebilecek risk faktörleri incelenerek 1,3,6,12 aylık
mortalite oranlarının nasıl etkilendiği değerlendirilmiştir.
Yöntem: Bu çalışmada 01.06.2014-01.06.2024 yılları arasında Necmettin Erbakan Üniversitesi
Tıp Fakültesinde takip edilen, ‘I85.0 Kanamalı Özofagus Varisleri’ İCD tanı kodu verilen tüm
hastalar hastane otomasyon sisteminden retrospektif olarak incelendi. İncelenen olguların
diyabetes mellitus (DM), hipertansiyon (HT) ve koroner arter hastalığı (KAH), hepatik
ensefalopati (HES), hepatorenal sendrom (HRS) varlığı ve MELD, CHİLD skorlamaları, yatış
süresince aldığı tedavileri ve endoskopik işlemleri incelendi. Elde edilen bulgular SPSS 22.0
paket programı kullanılarak analiz edilmiştir.
Bulgular: Çalışmamızda yapılan analizler sonucunda hastaların hayatta kalma süreleri kayıt
altına alınmış ve mortalite hızı açısından incelenmiştir. İncelenen mortaliteye etki edebilecek
faktörler arasında HES, HRS, KAH bulunmasının ve MELD skorunun >18,50 izlenmesinin
mortalite açısından etkili risk faktörleri olduğu izlenmiş bu risk faktörlerinin farklı takip
sürelerince izlenen mortalite incelenmesinde bağımsız değişken olarak mortalitenin ön
gördürücüleri olarak izlenmiştir. DM, HT komorbiditeleri mortaliteye etkisiz izlenmiştir.
Sonuç: Bu çalışmada sirotik OVK’ lı hastalarda kısa takip sürelerinde ileri evre MELD
skorlamasının ve Koroner Arter hastalığı bulunmasının mortalite oranlarının ciddi düzeyde
arttırdığı izlenmiş ayrıca hepatik yetmezlik ilişkili komorbidite durumlardan olan; HES ve
HRS’nin sağ kalımı ciddi oranda düşürdüğü izlenmiştir. Mortaliteye doğrudan etki eden bu
faktörlere yönelik koruyucu çalışmalar ve tedavi amacı ile yapılan çalışmalardaki gelişmeler
hastaların yaşam süresine olumlu katkıda bulunacaktır.
Objective: Esophageal variceal bleeding (OVB) is a serious complication of portal hypertension and carries a high risk of mortality during hospitalization. In this study, the demographic characteristics, clinical and laboratory findings, imaging and endoscopic results, mortality rates, and complications among patients admitted to Necmettin Erbakan University (NEU) Faculty of Medicine Hospital (FMH) with cirrhotic OVB were analyzed. The findings were compared to published data. Additionally, the riskfactors that may affect mortality were analyzed and the mortality rates at 1, 3, 6, 12 months were evaluated. Method: A retrospective review of the medical records was conducted for patients who were followed at NEU-FMH between June 1, 2014, and June 1, 2024, and who had an ICD diagnosis code of “I85.0 Esophageal Varices with Bleeding.” Comorbidities—including diabetes mellitus (DM), hypertension (HT), and coronary artery disease (CAD)—as well as hepatic encephalopathy (HES), hepatorenal syndrome (HRS), and Model for End-Stage Liver Disease (MELD) and Child–Pugh (CHILD) scores were recorded. Treatments administered during hospitalization and the endoscopic procedures that were performed were documented. These findings were analyzed using the SPSS (Bunun da ne olduğunu ilk defa kulandığın için yazman iyi olur) 22.0 software package. Results: In this study, advanced MELD scoring and the presence of coronary artery disease were found to significantly increase mortality rates in patients with cirrhotic OVB during short follow-up periods. Survival was significantly decreased by HES and HRS, which are hepatic failure-related comorbidities, as they contributed to increased mortality. It is suggested that preventive efforts targeting these mortality-associated factors, along with improvements in treatment strategies, could positively impact patient survival. Conclusion: In this study, it was observed that advanced-stage MELD scores and the presence of coronary artery disease significantly increased mortality rates in cirrhotic patients with variceal bleeding during short follow-up periods. Additionally, it was observed that hepatic encephalopathy (HES) and hepatorenal syndrome (HRS), which are comorbid conditions associated with hepatic failure, significantly reduced survival rates. Preventive measures and advancements in studies aimed at treating these factors, which directly impact mortality, are expected to contribute positively to the life expectancy of patients.
Objective: Esophageal variceal bleeding (OVB) is a serious complication of portal hypertension and carries a high risk of mortality during hospitalization. In this study, the demographic characteristics, clinical and laboratory findings, imaging and endoscopic results, mortality rates, and complications among patients admitted to Necmettin Erbakan University (NEU) Faculty of Medicine Hospital (FMH) with cirrhotic OVB were analyzed. The findings were compared to published data. Additionally, the riskfactors that may affect mortality were analyzed and the mortality rates at 1, 3, 6, 12 months were evaluated. Method: A retrospective review of the medical records was conducted for patients who were followed at NEU-FMH between June 1, 2014, and June 1, 2024, and who had an ICD diagnosis code of “I85.0 Esophageal Varices with Bleeding.” Comorbidities—including diabetes mellitus (DM), hypertension (HT), and coronary artery disease (CAD)—as well as hepatic encephalopathy (HES), hepatorenal syndrome (HRS), and Model for End-Stage Liver Disease (MELD) and Child–Pugh (CHILD) scores were recorded. Treatments administered during hospitalization and the endoscopic procedures that were performed were documented. These findings were analyzed using the SPSS (Bunun da ne olduğunu ilk defa kulandığın için yazman iyi olur) 22.0 software package. Results: In this study, advanced MELD scoring and the presence of coronary artery disease were found to significantly increase mortality rates in patients with cirrhotic OVB during short follow-up periods. Survival was significantly decreased by HES and HRS, which are hepatic failure-related comorbidities, as they contributed to increased mortality. It is suggested that preventive efforts targeting these mortality-associated factors, along with improvements in treatment strategies, could positively impact patient survival. Conclusion: In this study, it was observed that advanced-stage MELD scores and the presence of coronary artery disease significantly increased mortality rates in cirrhotic patients with variceal bleeding during short follow-up periods. Additionally, it was observed that hepatic encephalopathy (HES) and hepatorenal syndrome (HRS), which are comorbid conditions associated with hepatic failure, significantly reduced survival rates. Preventive measures and advancements in studies aimed at treating these factors, which directly impact mortality, are expected to contribute positively to the life expectancy of patients.
Açıklama
Anahtar Kelimeler
Özofageal varis kanaması, Esophageal variceal bleeding, Mortalite, Mortality, Siroz, Cirrhosis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Güzel, M. E. (2024). Özofageal varis kanamalı olgularda mortaliteye etki eden risk faktörleri. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
