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    Analysis of the patients with nonvariceal upper gastrointestinal bleeding and comparison of Rockall and Glasgow-Blatchford scores
    (Springer India, 2022) Aktaş, Gülali; Ustaoğlu, Müge; Bakır, Tülay; Aslan, Rahmi; Gören, Fikret; Bektaş, Ahmet
    Background Nonvariceal upper gastrointestinal bleeding (UGB) has important morbidity and mortality. Predicting high-risk patients for mortality and rebleeding is necessary for a treatment plan. In the present study, we aimed to define the epidemiological and etiological characteristics of patients presenting with nonvariceal UGB and to observe mortality and morbidity rates. We also aimed to compare Rockall and Glasgow-Blatchford scoring systems in predicting rebleeding and mortality. Methods Subjects presenting with nonvariceal UGB over a 3-year period were included. Demographic characteristics, symptoms, and signs on physical examination, laboratory data, endoscopic signs and diagnosis, interventions during hospitalization and follow-up period were recorded. Glasgow-Blatchford and Rockall scores were calculated for every participant at the first day of the admission. Results A total of 709 patients were enrolled in the study. A total of 490 of them (69.1%) were men. The mean age of the women and men was 60.7 +/- 1.2 and 58.6 +/- 0.7 years, respectively. Melena was the most common presenting symptom. Duodenal ulcer (31%), gastric ulcer (20.7%), and erosive disease (17.6%) were the most common causes of bleeding. History of use of aspirin and/or nonsteroidal anti-inflammatory drug use were present in 63.7% of the subjects. All patients were followed up for 30th-day mortality. Overall, rebleeding and mortality rates were 11% and 7%, respectively. A Rockall score greater than 6 was the most important predictor of mortality (odds ratio:39.1) and rebleeding (odds ratio:4.7). Conclusion Nonvariceal UGB patients with a Rockall score greater than 6 should undergo aggressive endoscopic treatment and inpatient care.
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    Elevated platelet distribution width and red cell distribution width are associated with autoimmune liver diseases
    (LIPPINCOTT WILLIAMS & WILKINS, 2021) Ustaoğlu, Müge; Aktaş, Gülali; Avcıoğlu, Ufuk; Bas, Berk; Bahçeci, Buğra Kaan
    Objective Red blood cell distribution width (RDW) and platelet distribution width (PDW) are reported to be associated with inflammation. We aimed to determine the association between RDW and PDW with autoimmune liver disease (ALD). Material and methods We retrospectively analyzed 126 patients who were diagnosed with ALD. Sixty-nine healthy individuals represented the control group. Characteristics and laboratory parameters of the ALD patients and control subjects were compared. Results The aspartate transaminase (AST) (P < 0.001), alanine transaminase (ALT) (P < 0.001), C-reactive protein (CRP) (P < 0.001), RDW (P < 0.001) and PDW (P < 0.001) levels of the ALD group were significantly higher than those of the control subjects. RDW was significantly correlated with AST (r = 0.17, P = 0.02) and CRP (r = 0.19, P = 0.01) levels. Moreover, PDW was significantly correlated with AST (r = 0.23, P = 0.002), ALT (r = 0.23, P = 0.001) and CRP (r = 0.23, P = 0.001) levels. The sensitivity and specificity of RDW higher than 13.7% level were 76% and 62%, respectively [AUC: 0.74, P < 0.001, 95% confidence interval (CI): 0.67-0.81]. The sensitivity and specificity of PDW higher than 17.9% level were 80% and 71%, respectively (AUC: 0.85, P < 0.001, 95% CI: 0.79-0.90). The sensitivity and specificity of CRP higher than 2.9 U/l level were 92% and 85%, respectively (AUC: 0.91, P < 0.001, 95% CI: 0.86-0.95). Conclusion Our study demonstrates that RDW and PDW have considerable sensitivity and specificity in determining ALD.