Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Has the Number of Upper Gastrointestinal Bleeding Cases Presenting to the Emergency Department Decreased During the COVID-19 Pandemic?: A Single-Center Experience
COVID-19 Pandemisinde Acil Servise Başvuran Üst Gastrointestinal Kanamalı Hastaların Sayısı Azaldı mı?: Tek Merkez Deneyimi
Abdullah Murat BUYRUKa, Elif ARTUTb, Ali ŞENKAYAc, Aydın AKTAŞb, Mustafa ÇİÇEKd, Ayten LİVAOĞLUe, Seymur ASLANOVc, Eser BULUTf
aClinic of Gastroenterology, Kanuni Training and Research Hospital, Trabzon, Türkiye
bClinic of General Surgery, Kanuni Training and Research Hospital, Trabzon, Türkiye
cDepartment of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
dClinic of Emergency, Kanuni Training and Research Hospital, Trabzon, Türkiye
eClinic of Pathology, Kanuni Training and Research Hospital, Trabzon, Türkiye
fClinic of Radiology, Kanuni Training and Research Hospital, Trabzon, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(3):171-7
doi: 10.5336/medsci.2021-87373
Article Language: EN
Full Text
ABSTRACT
 Objective: In the period of the coronavirus disease-19 (COVID-19) pandemic, upper gastrointestinal endoscopy was either postponed or canceled, except for emergencies, due to the high risk of transmission. Our study aimed to evaluate the effect of the COVID-19 pandemic on patients with upper gastrointestinal bleeding presenting to the emergency department and to compare it with the data before the pandemic. Material and Methods: In this single-center, retrospective study, patients were divided into 2 groups: pre-COVID-19 (pre-C) (March 2019-March 2020) and post-COVID-19 (post-C) (March 2020- March 2021). Patients who presented to the emergency department with upper gastrointestinal bleeding during these periods and underwent endoscopic examination were included in the study. Results: Endoscopy for upper gastrointestinal bleeding was urgently performed in 125 patients in the pre-C period and in 89 (29% decrease) patients in the post- C period. The Glasgow-Blatchford Score was higher in the pre-C period (p=0.02). Peptic ulcers were the most common cause of bleeding in both groups. High-risk peptic ulcer (forrest 1a/1b/2a/2b), and malignancy were observed more frequently in the post-C period (p=0.003, p=0.04; respectively). Endoscopic combined treatment rate was higher in the post-C group (p<0.001). Re-bleeding ratios were similar for both the groups (p=0.48). Conclusion: During the post-C period, the number of upper gastrointestinal bleeding cases admitted to the emergency department decreased significantly. However, the rate of high-risk peptic ulcer and malignancy in the etiology of upper gastrointestinal bleeding increased in the post-C period.

Keywords: COVID-19; upper gastrointestinal bleeding; emergency department
ÖZET
 Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-19 (COVID-19)] pandemisinde üst gastrointestinal sistem endoskopisi, bulaş açısından yüksek riskli olması nedeniyle acil vakalar dışında ertelenmiş veya iptal edilmiştir. Çalışmamızın amacı, COVID-19 pandemisinin acil servise başvuran üst gastrointestinal kanamalı hastalar üzerindeki etkisini, COVID-19 öncesi dönem ile karşılaştırarak değerlendirmektir. Gereç ve Yöntemler: Tek merkezli, retrospektif çalışmada hastalar COVID-19 öncesi (pre-C) (Mart 2019-Mart 2020) ve COVID-19 sonrası (post-C) (Mart 2020-Mart 2021) olmak üzere 2 dönem olarak gruplandı. Bu dönemlerde, acil servise üst gastrointestinal kanaması nedeniyle başvuran ve endoskopik inceleme yapılan hastalar çalışmaya dâhil edildi. Bulgular: Pre-C dönemde 125 hastada, post-C dönemde ise 89 (%29 azalma) hastaya üst gastrointestinal kanaması nedeniyle acil endoskopi uygulandı. Glasgow-Blatchford Skoru, pre-C döneminde daha yüksekti (p=0,02). Her iki grupta da en sık kanama nedeni peptik ülserdi. Kanama etiyolojisinde yüksek riskli peptik ülser (forest 1a/1b/2a/2b) oranı ve malignite oranı post-C dönemde daha fazlaydı (sırayla p=0,003, p=0,04). Endoskopik kombine tedavi oranı post-C grupta daha fazla fazlaydı (p<0,001). Tekrar kanama oranları her iki grup için benzerdi (p=0,48). Sonuç: Post-C döneminde acil servise başvuran üst gastrointestinal kanamalı hasta sayısı belirgin azalmıştır. Post-C dönemde üst gastrointestinal kanama etiyolojisinde yüksek riskli peptik ülser ve malignite oranı artmıştır.

Anahtar Kelimeler: COVID-19; üst gastrointestinal kanama; acil servis
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