Association between ABO blood groups and mortality in upper gastrointestinal bleeding.

OBJECTIVE: Gastrointestinal bleeding is an important part of gastrointestinal emergencies. This study aimed to examine the association between ABO blood groups and mortality in patients who were admitted to the emergency department and diagnosed with upper gastrointestinal bleeding. METHODS: The patients with upper gastrointestinal bleeding in the emergency department of a tertiary hospital in Turkey and the data of healthy blood donors were studied. The data of these patients were analyzed, and it was determined that the primary outcome was in-hospital mortality. RESULTS: The study was completed with 274 patients and 274 control group. The mean age of these patients was 65.1±18.2 years, and 64.2% of patients were males. It was found that the in-hospital mortality rate of patients with O blood group (16.2%) was statistically significantly higher than non-O blood group (7.5%) (p:0.032). CONCLUSION: The study concluded that the mortality rate of gastrointestinal bleeding patients with O blood group was higher compared to patients with other blood groups. Physicians can use ABO blood groups to predict mortality risk in gastrointestinal bleeding.

Investigation of the prognostic role of systemic immunoinflammatory index in patients with acute pancreatitis.

BACKGROUND: The aim of this study was to examine the effect of systemic immunoinflammatory index (SII), calculated on presentation to the emergency department (ED), on the prediction of clinical outcomes of patients who were diagnosed with acute pancreatitis (AP). METHODS: This research was designed as a single-center, cross-sectional, and retrospective study. Adult patients who were diag-nosed with AP in the ED between October 2021 and October 2022 in the tertiary care hospital, whose diagnostic and therapeutic procedures were complete in the data recording system, have been included in the study. RESULTS: Mean age, respiratory rate, and length of stay of the non-survivors were significantly higher than the mean of the survivors (t-test, p=0.042, p=0.001, and p=0.001, respectively). Mean SII score of the patients with fatal outcome was higher than the survivors (t-test, p=0.001). ROC analysis of the SII score to predict mortality revealed that the area under the curve was found to be 0.842 (95%CI 0.772-0.898), and the Youden index was 0.614, (p=0.001). When the cutoff value of the SII score in determining mortality is 1243, the sensitivity of the score was found to be 85.0%, specificity 76.4%, positive predictive value 37.0%, and negative predictive value 96.9%. CONCLUSION: SII score was statistically significant in estimating mortality. SII calculated on presentation to the ED can be a useful scoring system to predict the clinical outcomes of patients who were admitted to the ED and were diagnosed with AP.

Use of the AIMS65 and pre-endoscopy Rockall scores in the prediction of mortality in patients with the upper gastrointestinal bleeding.

BACKGROUND: Upper gastrointestinal (GI) bleeding is one of the most common reasons for emergency department (ED) visits. This study aimed to evaluate the predictive power of the AIMS65 and pre-endoscopy Rockall scores in predicting in-hospital mortality in patients that presented to ED and were diagnosed with the upper GI bleeding. METHODS: Data of patients aged 18 years and older, who visited ED of Kartal Dr. Lütfi Kirdar City Hospital during the study period and were diagnosed with upper GI bleeding, were obtained from the electronic-based hospital information system and analyzed retrospectively. Each scoring system was compared using the receiver operating characteristic (ROC) curve analysis. RESULTS: The study was completed with 592 patients. The mean age of the patients was 63.5±19.0 years, and 68.6% were male. The total in-hospital mortality rate was 5.2%. In the ROC analysis of the AIMS65 and pre-endoscopy Rockall scores in the prediction of in-hospital mortality, the area under the curve values was calculated as 0.822 (95% confidence interval [CI]: 0.788-0.852) and 0.777 (95% CI: 0.741-0.810), respectively. When these two scoring systems were compared, neither had statistically significant superiority over the other in predicting in-hospital mortality. CONCLUSION: The AIMS65 and pre-endoscopy Rockall scores can be used to predict in-hospital mortality in patients with GI bleeding. However, since the AIMS65 score consists of only five variables that can easily be calculated in ED, we recommend its use in clinical practice.

The Effects of Intravenous Lipid Emulsion Therapy in the Prevention of Depressive Effects of Propofol on Cardiovascular and Respiratory Systems: An Experimental Animal Study.

Background and objectives: Although there are several hypotheses about the mechanism of action, intravenous lipid emulsion (ILE) therapy has been shown to be effective in the treatment of toxicities due to local anaesthetics and many lipophilic drugs. In this study, we had hypothesized that ILE therapy might also be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into four groups. Saline was administered to the subjects in the control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth group was administered propofol and ILE therapy together (ILE+PP group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mortality were recorded at 10 time-points during a period of 60 min. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group; SBP, DBP, RR, and HR levels declined steadily; and all rats in this group died after the 60-min period. In the ILE+PP group, the initially reduced SBP, DBP, RR, and HR scores increased close to the levels observed in the control group. The SBP, DBP, RR, and HR values in the PP group were significantly lower compared to the other groups (p < 0.01). The mortality rate was 100% (with survival duration of 60 min) for the PP group; however, it was 0% for the remaining three groups. Conclusions: Our results suggest that the untoward effects of propofol including hypotension, bradycardia, and respiratory depression might be prevented with ILE therapy.