Researching the effects of visualization of vena cava inferior and aortic diameter by ultrasound on hospitalization, discharge and morbiity in patients admitted to the emergency department with upper gastrointestinal hemorrhage

Objective: Gastrointestinal system (GIS) bleeding is critical in emergency department admissions due to high mortality, morbidity, and hospitalization costs. Upper GİS bleeding is the most common type. Ultrasonography (USG) can be utilized as a rapid and noninvasive method in patients admitted to the emergency department due to upper GIS bleeding. We aimed to investigate the impact of ultrasonographic examination of the calibers of vena cava inferior (VCI) and aorta on hospital admissions, discharge from hospital, and morbidity and mortality in patients with upper GIS bleeding. Materials and Methods: Forty-five patients older than 18 years old, who were admitted to the emergency department of Ankara Şehir Hastanesi due to upper GIS bleeding from 01/02/2019 to 01/10/2019, were included in study as control group with 45 volunteers without hypovolaemia. The diameters of VCI and aorta were measured with USG and recorded prospectively. Results: The mean age was 67±19 years in patient group and it was 74±9 in control group. The mean values of the expiratory diameter, inspiratory diameter, and VCI collapsibility index in control and patient group were 18.47±2.5 mm, 15.2±2.4 mm, 0.18±0.06 mm; 15.56±3.6 mm, 13.2±3 mm, 0.15±0.12 respectively. The mean values of the suprarenal and infrarenal diameters of aorta in control and patient group were 24.3±2.2 mm, 21.7±2.3 mm; 19.0±3.6 mm, 17.0±3.4 mm, respectively. Intergroup comparisons revealed significantly lower values in all of these parameters in patient group compared to control group (p<0.001). Conclusion: In our study; diameters of VCI and aorta and VCİ collapsibility index were lower in patients with upper GIS bleeding compared to control group. Despite utility of these parameters as adjuncts in making the diagnosis in emergency department, no impacts of these low values were identified on decision-making process of hospital admissions or discharges. This issue can be investigated in more detail with more comprehensive studies. Key Words: Upper gastrointestinal bleeding, vena cava inferior diameter, aorta diameter and vena cava inferior collapsibility index.