PREDICTORS OF RECURRENCE ACUTE NON VARICEAL UPPER GASTROINTESTINAL BLEEDING

Based on the data analysis performed on 401 patients treated at the municipal budgetary institutions Health «City Emergency Hospital», of Rostov-on-Don city, from 2014 to 2018. The validity of the possible predictors of recurrence of gastrointestinal bleeding was determined. Inclusion criteria were: Diagnosis of ICD 10: K 25.0. K 25.4, K 26.0, K 26.4, informed consent of the patient. Exclusion criterion: gastrointestinal bleeding due to portal hypertension, Mallory-Weiss syndrome, and symptomatic ulcers. The patients were divided into groups: Group 1: No bleeding recurrence 87,53 % (351). Group 2: Recurrent bleeding 12,47 % (50). What are established as predictors of recurrence of gastrointestinal bleeding are: severe bleeding, and bleeding Forrest 1a. To these patients with ineffective endoscopy, emergency surgical treatment is indicated. Predictors of moderate prognostic signifi ance of recurrent bleeding include comorbidity, anamnesis, Rockall score ≥ 8 points, systolic blood pressure ≤ 100 мм рт. ст., heart rate ≥ 100 bpm, total protein ≤ 55 g/l, urea ≥ 10,0 mmol/l, PTT ≥ 45 sec, HGB ≤ 100 g/l, thrombocytes ≥ 350 х 109/l. When predictors of moderate severity of recurrent bleeding are identifi d, transluminal endoscopic surgery is required. Predictors of low signifi ance of recurrent bleeding are age ≥60 year, bleeding Forrest 1b и 2b, Glasgow-Blatchford bleeding score ≥ 13 points, creatinine ≥ 240 mkmol/l, patients in need of prolonged observation in a hospital. In patients without recurrence of bleeding, endoscopy is the ultimate hemostasis in 97,15 %. With recurrence of bleeding, endoscopy is effective in 36.0%. Predictors of recurrence of bleeding are: severe bleeding, objective indications for blood transfusion, repeated blood transfusion, age>70 year, comorbidity, long term use of anticoagulants, history of ulcer, total protein in plasma < 55 g/l, PTT > 45 sec, thrombocytes ≥ 350 х 109/l, as well as disseminated intravascular coagulation.

acute nonvariceal upper gastrointestinal bleeding, death rate, prognosis, recurrence, risk factors