학술논문
A Comparison of Drug Regimens and Analysis of Effective Factors for Blood Transfusion and Intervention in Spontaneous Rectus Sheath Hematomas/Spontan Rektus Kilif Hematomlari: Ilac Rejimlerinin Karsilastirilmasi ve Kan Transfuzyonu ve Mudahalesi icin Etkili Faktorlerin Analizi
ORIGINAL INVESTIGATION
ORIGINAL INVESTIGATION
Document Type
Report
Author
Source
Istanbul Kanuni Sultan Suleyman Medical Journal (Istanbul Kanuni Sultan Suleyman Tıp Dergisi). September 2021, Vol. 13 Issue 3, p213, 9 p.
Subject
Language
English
ISSN
2148-273X
Abstract
INTRODUCTION Rectus sheath hematoma (RSH) is usually caused by damage to the superior and inferior epigastric arteries and their branches or directly to the rectus muscle (1). Diagnosis of RSH [...]
Objective: Rectus sheath hematomas (RSH) are mostly observed in older patients with a high number of comorbidities. The use of anticoagulants is the most common risk factor for the disease. Our study aimed to determine the effect of the drug regimens and analyze the risk factors for blood transfusion and intervention in cases of RSH. Method: The records of 46 patients who had been treated for RSH between January 2015 and March 2020 were analyzed retrospectively. The demographic data, drug usage, tomography findings, clinical courses, and morbidity and mortality rates of the patients were recorded. The findings were compared according to the drug regimens, and the risk factors for blood transfusion and intervention were determined. Results: The mean erythrocyte transfusion (3.61 U), number of patients who underwent erythrocyte transfusion (77%), mean hematoma size (10.07 cm), and length of hospital stay (7.53 days) were higher in Group 1 (only using acetylsalicylic acid) patients (p = 0.002, p = 0.011, p = 0.016, and p = 0.004, respectively). The common risk factors for blood transfusion and intervention, however, were low hemoglobin levels, contrast extravasation and type-3 hematoma on computed tomography (CT), and long hospital stay. Conclusion: RSH are usually treated conservatively. Blood transfusion, vascular embolization, and/or surgical treatment may be required. Only acetylsalicylic acid use, low hemoglobin levels, long hospital stay, and contrast extravasation, and type 3 hematoma on CT were associated with more blood transfusion and intervention. Keywords: Rectus sheath, hematoma, conservatively, blood transfusion, vascular embolization Amac: Rektus kilifi hematomlari (RKH) siklikla komorbiditesi yuksek yasli hastalarda gorulmektedir. Antikoagulan kullanimi, hastalik icin en yaygin risk faktorudur. Bu calisma, rektus kilif hematomunda ilac rejimlerinin etkisini belirlemeyi ve kan transfuzyonu ve mudahale icin risk faktorlerini analiz etmeyi amaclamaktadir. Yontem: Ocak 2015 ile Mart 2020 arasinda rektus kilif hematomu nedeniyle tedavi edilen 46 hastanin dosyasi geriye donuk olarak incelendi. Hastalarin demografik verileri, ilac kullanimi, bilgisayarli tomografi (BT) bulgulari, klinik seyirleri, morbidite ve mortalite oranlari kaydedildi. Veriler hastalarin kullandiklari ilac rejimleri arasinda karsilastirildi ve kan transfuzyonu ve mudahale icin risk faktorleri belirlendi. Bulgular: Ortalama eritrosit transfuzyonu (3,61 U), eritrosit transfuzyonu yapilan hasta sayisi (%77), ortalama hematom boyutu (10,07 cm) ve hastanede kalis suresi (7,53 gun) Grup 1'de daha yuksekti (sirasiyla; p = 0,002, p = 0,011, p = 0,016, p = 0,004). Kan transfuzyonu ve cerrahi veya girisimsel embolizasyon icin etkili olan ortak risk faktorleri, dusuk hemoglobin seviyeleri, BT anjiyografide kontrast ekstravazasyonu ve tip 3 hematom ve uzun hastanede kalisi olarak bulunmustur. Sonuc: Rektus kilifi hematomlari genellikle konservatif olarak tedavi edilir. Kan transfuzyonu, vaskuler embolizasyon ve/veya cerrahi tedavi gerekebilir. Sadece asetilsalisilik asit kullanimi, dusuk hemoglobin seviyeleri, uzun hastanede kalis, BT'de kontrast ekstravazasyon ve tip 3 hematom daha fazla kan transfuzyonu ve mudahalesi ile iliskilendirildi. Anahtar kelimeler: Rektus kilif hematomu, konservatif tedavi, kan transfuzyonu, vaskuler embolizasyon
Objective: Rectus sheath hematomas (RSH) are mostly observed in older patients with a high number of comorbidities. The use of anticoagulants is the most common risk factor for the disease. Our study aimed to determine the effect of the drug regimens and analyze the risk factors for blood transfusion and intervention in cases of RSH. Method: The records of 46 patients who had been treated for RSH between January 2015 and March 2020 were analyzed retrospectively. The demographic data, drug usage, tomography findings, clinical courses, and morbidity and mortality rates of the patients were recorded. The findings were compared according to the drug regimens, and the risk factors for blood transfusion and intervention were determined. Results: The mean erythrocyte transfusion (3.61 U), number of patients who underwent erythrocyte transfusion (77%), mean hematoma size (10.07 cm), and length of hospital stay (7.53 days) were higher in Group 1 (only using acetylsalicylic acid) patients (p = 0.002, p = 0.011, p = 0.016, and p = 0.004, respectively). The common risk factors for blood transfusion and intervention, however, were low hemoglobin levels, contrast extravasation and type-3 hematoma on computed tomography (CT), and long hospital stay. Conclusion: RSH are usually treated conservatively. Blood transfusion, vascular embolization, and/or surgical treatment may be required. Only acetylsalicylic acid use, low hemoglobin levels, long hospital stay, and contrast extravasation, and type 3 hematoma on CT were associated with more blood transfusion and intervention. Keywords: Rectus sheath, hematoma, conservatively, blood transfusion, vascular embolization Amac: Rektus kilifi hematomlari (RKH) siklikla komorbiditesi yuksek yasli hastalarda gorulmektedir. Antikoagulan kullanimi, hastalik icin en yaygin risk faktorudur. Bu calisma, rektus kilif hematomunda ilac rejimlerinin etkisini belirlemeyi ve kan transfuzyonu ve mudahale icin risk faktorlerini analiz etmeyi amaclamaktadir. Yontem: Ocak 2015 ile Mart 2020 arasinda rektus kilif hematomu nedeniyle tedavi edilen 46 hastanin dosyasi geriye donuk olarak incelendi. Hastalarin demografik verileri, ilac kullanimi, bilgisayarli tomografi (BT) bulgulari, klinik seyirleri, morbidite ve mortalite oranlari kaydedildi. Veriler hastalarin kullandiklari ilac rejimleri arasinda karsilastirildi ve kan transfuzyonu ve mudahale icin risk faktorleri belirlendi. Bulgular: Ortalama eritrosit transfuzyonu (3,61 U), eritrosit transfuzyonu yapilan hasta sayisi (%77), ortalama hematom boyutu (10,07 cm) ve hastanede kalis suresi (7,53 gun) Grup 1'de daha yuksekti (sirasiyla; p = 0,002, p = 0,011, p = 0,016, p = 0,004). Kan transfuzyonu ve cerrahi veya girisimsel embolizasyon icin etkili olan ortak risk faktorleri, dusuk hemoglobin seviyeleri, BT anjiyografide kontrast ekstravazasyonu ve tip 3 hematom ve uzun hastanede kalisi olarak bulunmustur. Sonuc: Rektus kilifi hematomlari genellikle konservatif olarak tedavi edilir. Kan transfuzyonu, vaskuler embolizasyon ve/veya cerrahi tedavi gerekebilir. Sadece asetilsalisilik asit kullanimi, dusuk hemoglobin seviyeleri, uzun hastanede kalis, BT'de kontrast ekstravazasyon ve tip 3 hematom daha fazla kan transfuzyonu ve mudahalesi ile iliskilendirildi. Anahtar kelimeler: Rektus kilif hematomu, konservatif tedavi, kan transfuzyonu, vaskuler embolizasyon