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Dejavniki bolnišnične umrljivosti bolnikov z akutno obilno krvavitvijo iz zgornjega dela prebavne cevi = Predictive factors of in-hospital mortality in patients with acute severe upper gastrointestinal bleedingSinkovič, AndrejaIzhodišča. Dejavniki umrljivosti akutne težke krvavitve iz zgornjega dela prebavne cevi so visoka starost, spremljajoče bolezni in endoskopski dokaz aktivne krvavitve. Naš cilj je prikaz neodvisnih ... dejavnikov bolnišnične umrljivosti pri naših bolnikih s težko akutno krvavitvijo iz zgornje prebavne cevi. Metode. Retrospektivno smo pregledali popise 54 bolnikov, sprejetih zaradi akutne krvavitve iz zgornjega dela prebavil, dokazano endoskopsko in/ali s hipotenzijo in/ali tahikardijo. Dejavniki umrljivosti so bili testirani z univariantno in multivariantno statistično metodo. Rezultati. Najpogostejši vzrok krvavitve so bile varice in erozije, nato peptična razjeda. Umrljivost naših bolnikov je bila 31,5 %. Med umrljimi in preživelimiso bile statistično pomembne razlike v prisotnosti hemoragičnega šoka (82,4 % vs. 27 %, p<0,001), odpovedi srca (76,5 % vs. 18,9 %, p<0,001), okužbi (47 % vs. 10,8 %, p=0,005), sprejemnem diastoličnem krvnem tlaku (55,4 +/- 22 mm Hg vs. 69,7 +/- 17,7 mmHg, p=0,016), sprejemnem hemoglobinu (74,2 +/- 25,7 g/L vs. 94,2 +/- 22,2 g/L, p=0,005) in eritrocitih (2,4 +/-0,7 10, 10 [na] 12/L vs. 3 +/- 0,7 10.10 [na] 12 /L, p=0,005, v najnižjem hemoglobinu (65,8 +/- 24,3 g/L vs. 80 +/- 18,3 g/L, p=0,02) in eritrocitih (2 +/- 0,7 10.10 [na] 12/L vs.2,5 +/- 0,6 10.10 [na] 12/L, p=0,007) med zdravljenjem. Glede na logistično regresijo je najpomembnejši neodvisni dejavnik umrljivosti naših bolnikov odpoved srca in ožilja, nato najnižji hemoglobin in eritrociti med zdravljenjem. Zaključki. Krvavitve iz varic so bile najpogostejši vzrok akutne krvavitve iz zgornjih prebavil. Najpomembnejši neodvisni dejavnik bolnišnične umrljivosti, ki je bila 31.5 %, je bolezen srca in ožilja.Source: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 75, supl. II, 2006, str. II-63 - II-68)Type of material - article, component part ; adult, seriousPublish date - 2006Language - slovenianCOBISS.SI-ID - 2487103
source: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 75, supl. II, 2006, str. II-63 - II-68)
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Sinkovič, Andreja | 18987 |
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