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
Abstract
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).
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.