Anemia prevelance and clinical approach in patiens with gastrointestinal bleedi̇ng

Introduction And Aim: Acute gastrointestinal system (A-GIS) hemorrhages are frequent. Anemia is frequently seen in these patients at the discharge from the hospital. Studies intended to these patients' follow up after discharge and anemia treatment are limited and there are no guidelines on this topic. The anemia prevalance and approach to the anemia in patients with A-GIS bleeding at the time of discharge and during 3 months' follow-up has been evaluated in this study. Material and Method: In this study 197 patients diagnosed A-GIS bleeding in our hospital between January 2015 –May 2016 have been evaluated retrospectively. At the time of discharge, the anemia was accepted as hemoglobin levels lower than 13 g/dL in males, 12 g/dL in females according to the WHO criteria. Results: In 129 of these patients upper gastrointestinal endoscopy, in 3 of them enteroscopy, in 45 of them lower gastrointestinal endoscopy, in 8 of them both upper and lower gastrointestinal endoscopy, in 2 of them upper, middle and lower gastrointestinal endoscopies were applied and 10 patients were not treated. In 69 of these patients therapeutic endoscopic treatments were applied. The mean of the length of hospitalization was 9.66±13.84 day and 67% of patients had erythrocyte transfusion with a mean value of 3.5±5.89 units during hospitalization. The mean of hemoglobin rate was 9.85±1.67 g/dL at the time of discharge from the hospital. In 92.4 % of the patients (F 91.1%, M 93.2%; upper GI bleeding 93.9%, middle GI bleeding 100%, lower GI bleeding 86.8%) anemia was detected at the time of the discharge. In 9.7% of these patients, iron deficiency treatment were applied. 33% of all 197 patients were evaluated 3 months after discharge from the hospital and in 80 % of these patients had still ongoing anemia. Conclusion: Anemia ratio is high when the patients with A-GIS bleeding are discharged. Most patients are discharged without receiving a prescription for the anemia. In follow-up, control applications are inadequate and anemia persists in patients. There is a need for a wider range of patient studies on how treatment should be applied and how to follow it, as well as guidelines from the consensus body on this issue.