The importance
of initial values of blood pressure and heart rate in the
evaluation of prognosis of patients with serious endoscopic
findings in the upper part of gastrointestinal tract
Burešová M., Keil R., Hrdlička L., Goláňová J., Šťovíček J., Drábek J., Tyburec J., Chudý J., Lochmannová J.
Interní klinika FN v Motole, Praha Přednosta: prof. MUDr. Milan Kvapil, CSc. |
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Summary:
Introduction: Only limited information about status of patiens
with bleeding in the gastointestinal tract is available before
urgent endoscopy is performed. The blood pressure and heart
rate belong to the substantial ones. On this information the
decision about next diagnostic and therapeutic process is
based.
In our retrospective study we have tried to find the relationship
between initial values for patient blood pressure and heart
rate and prognosis of the patient.
Methods: We have retrospectively reviewed 52 patients who
underwent urgent upper endoscopy in our gastroenterology
clinic for acute bleeding in the upper part of gastrointestinal
tract and had significant endoscopic findings. In these patients
we have evaluated the relationship between initial values
of their blood pressure and heart rate and their mortality. The
other parameters that we have followed were Rockall score,
the age of the patiens, initial value of hemoglobin, the length
of hospital stay, and the length of the hospital stay in the intensive
care unit, and also the number of given transfusions.
We have divided patients into two groups according to values
of blood pressure and heart rate: group A stable patients
(systolic blood pressure > 100 mm Hg and pulse < 100/min)
and group B – unstable patients (systolic blood pressure <
100 mm Hg and pulse > 100 /min).
Results: Stable patients have less blood transfusion during
hospitalisation,their hospitalisation at the intensive care unit
and total time of hospitalisation was shorter then in the group
of unstable patients.
In group A there was not statistically significant difference in
hospital mortality compared to patients in group B .
Conclusion: Based on our results we can conclude that the
difference between hospital mortality in unstable patients with
hypotension and tachycardia (group B) was not statistically
significant compared to the stable patients without hypotension
and tachycardia – group A (p>0.05).
The value of initial hemoglobin concentration was equal in
both groups of patients. The number of received transfusions
was significantly higher in the group of unstable patients.
From our study we can conclude that the initial blood pressure
and heart rate were not predicting prognosis of patients.
The time of intensive care unit hospitalisation was longer in
the group of unstable patients, these patients also received
more blood transfusions.
Key words:
Blood pressure, heart rate, prognosis, mortality,
gastrointestinal bleeding.
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