Evaluation of the relationship between the leukocytes count and the clinical course in non-variceal upper gastrointestinal system bleeding

Süle M. Evaluation of the Relationship Between the Leukocytes Count and the Clinical Course in Non-Variceal Upper Gastrointestinal System Bleeding, Adnan Menderes University Faculty of Medicine, Department of Internal Medicine, Thesis of Internal Medicine Specialty, Aydın, 2017 In this study, it was aimed to evaluate the effect of some variables, especially the leukocyte count, on the prognosis of the disease in patients with non-variceal gastrointestinal bleeding who were admitted to the gastroenterology clinic between the dates of September 2013 and March 2017. The study was a retrospective cross-sectional study. Among the patients (n=156), males were twice as often as females. When means of some blood values of the patients were evaluated, Hgb (9.8 g / dL) and Hct (30.4%) values were below normal limits and mild leukocytosis (10 545 / mm3) was found, consistent with the bleeding. When some treatment features of hemorrhagic patients were examined, a maximum of 10; average 2,6 ± 2,2 units eritrocyte suspension, and a maximum 9; an average of 0.6 ± 1.8 units fresh frozen plazma replacement was performed. Approximately half of the patients were followed up in intensive care unit (43.6%). A small number of patients were intervened surgically and a small number of patients lost their lives (2,6%). Patients were hospitalized for an average of 5.23 ± 3.01 days, 19 days maximum. Duodenal ulcers were more frequent in males (F 20.5%, M: 57.3%, p = 0.001) while females had more gastric ulcers (F: 61.5% -M: 34.1%, p = 0.001) and both were statistically significant. Comparison between leucocyte count below and above 10 000 / mm3 showed no statistical difference in of eritrocyte suspension and fresh frozen plazma replacement, hospitalization, intensive care follow-up, surgical intervention and treatment outcome. Patients with a neutrophil / lymphocyte ratio less than 1.65 were followed up at an average of 3.3 days in the hospital and those with a 1.65 or more neutrophil/ lymphocyte ratio were followed up at an average of 5.4 days (p = 0.02). There was no relationship between the leukocyte count and the predictability of the disease prognosis. Extensive research on the effect of the number of leukocytes and other variables on the prognosis of the disease is needed. There is a significant relationship between the neutrophil / lymphocyte ratio and the length of hospitalization, but there is a need for a large scale study of the relationship between the rate of neutrophil / lymphocyte at presentation and upper gastrointestinal bleeding prognosis. Keywords: Gastroenterology, Non-variceal Upper Gastrointestinal Bleeding, Leukocyte Count, Neutrophil / Lymphocyte Ratio