Clinical and statistical aspects of gastrointestinal bleeding course in patients with cardiovascular system pathology.

Authors

DOI:

https://doi.org/10.26641/2307-0404.2019.1.162176

Keywords:

gastrointestinal bleeding, pathology of the cardiovascular system, Forrest

Abstract

We have collected, processed and analyzed the results of treatment of 329 patients with gastrointestinal bleedings in which the course of the underlying disease is aggravated by the pathology of the cardiovascular system, in Communal institution "Dnipro Clinical Emergency Care Association" of Dnipro City Council» in the period for 2017. First, the frequency of background diseases was determined, chronic pathology being 93.4%. Ischemic heart disease (IHD): cardiosclerosis of various origins (post-infarction, diffuse, atherosclerotic), hypertonic disease (HD) - HD-I, HD-II, HD-III are the most common, while acute disorders of cerebral circulation, the state after coronary artery bypass surgery, renal artery bypass, arrhythmias, acute myocardial infarction made up 16 (5%), 1 (0.3%), 3 (1%), 1 (0.3%), respectively. Secondly, the quality of endoscopic hemostasis in case of ulcerative bleeding from the stomach, duodenum, gastroenteroanastomosis, was assessed by Forrest classification, connecting the results with the accompanying pathology of the cardiovascular system. We found that active bleeding F I was determined in 24 people (7.3%), of which F Ia – in 14 (4.3%), F Ib – in 10 (3%). Unstable hemostasis with a high risk of recurrent F II bleeding, was observed in 251 patients, which makes up 76.2%, and F III – in 54 (16.5%). The degree of blood loss was directly influenced by drug – anticoagulants, antiplatelet agents, hypotensive drugs, as well as their combinations, aimed at correcting the rheological properties of blood. Depending on the degree of blood loss, the quality of hemostasis, the general condition of the patient, the treatment tactics for this cohort of patients was determined. 313 patients received conservative treatment, which made up 95.1%. 16 patients were operated. Postoperative mortality is 12,5%. The overall mortality of the above cohort is 10%.

Author Biographies

N. V. Trofimov

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of General Surgery
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

V. P. Kryshen

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of General Surgery
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

S. I. Barannik

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of General Surgery
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

A. V. Chukhryenko

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of General Surgery
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

G. N. Chabanenko

CI «Dnipro Clinical Emergency Care Association» DCC»  
V. Antonovycha st., 65, Dnipro, 49006, Ukraine

A. N. Gayterov

CI «Dnipro Clinical Emergency Care Association» DCC»  
V. Antonovycha st., 65, Dnipro, 49006, Ukraine

References

Bereznytskyi YS, Mishalov VH, Zakharash MP. Surgery: textbook for students of higher medical educa­tional institutions. Nova Knyha. 2016:712. Ukrainian.

Verbitsky VG, Bagnenko SF, Kurygin AA. [Gas­trointestinal bleedings of ulcer etiology: Pathogenesis, diagnosis, treatment]. Moskva, Politekhnika. 2004;242. Russian.

Glazova AV, Poteshkina NG. [Gastroprotection in patients receiving non-steroidal anti-inflammatory drugs and antithrombotic therapy]. Rossiyskiy medi­tsinskiy Journal. 2012;1:46-50. Russian.

Gostishchev VK, Yevseyev MA. [Gastroduodenal bleeding of ulcerative etiology]. GEOTAR-Media. 2016;384. Russian.

Grigoryan RA. [Abdominal surgery: in 2 volu­mes]. OOO «Meditsinskoe informatsionnoe agenstvo». 2006;1:226-66. Russian.

Rozanov BS. [Gastric hemorrhages and their surgical treatment]. Gosudarstvennoye izdatelstvo medi­tsinskoi literatury. 2015;196. Russian.

Skvortsov VV, Tumarenko AV. [Clinical Gastro­enterology]. Kurs dlya vrachei. 2015;55-57. Russian.

Fomin PD, Nikishev VI. [Bleeding from the upper gastrointestinal tract: causes, risk factors, diagnosis, treatment]. Zdorovye Ukrainy. 2010;5:8-10. Ukrainian.

Iwamoto J, Saito Y, Honda A, Matsuzaki Y. Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy. World J Gastro­enterol. 2013;19(11):1673-82. doi: https://doi.org/10.3748/wjg.v19.i11.1673

Forrest JA, Finlayson ND, Shearman DJ. Endo­scopy in gastrointestinal bleeding. Lancet 2. 1974 Aug;7877:394-7. https://doi.org/10.1016/S0140-6736(74)91770-X

Uemura N, Sugano K, Hiraishi H, Shimada K, Goto S, Uchiyama S, et al. Risk factor profiles, drug usage, and prevalence of aspirin-associated gastro­duodenal injuries among high-risk cardiovascular Japa­nese patients: The results from the MAGIC study. J Gastroenterol. 2014;49. doi: https://doi.org/10.1007/s00535-013-0868-0.

How to Cite

1.
Trofimov NV, Kryshen VP, Barannik SI, Chukhryenko AV, Chabanenko GN, Gayterov AN. Clinical and statistical aspects of gastrointestinal bleeding course in patients with cardiovascular system pathology. Med. perspekt. [Internet]. 2019Apr.12 [cited 2024Jun.17];24(1):35-9. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/162176

Issue

Section

CLINICAL MEDICINE