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Course of hospitalization of patients referred on an emergency basis due to bleeding into the gastrointestinal tract.

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Bojanowski A., Mitura K., Kisielewski K., Leszczyński P. K.

Critical Care Innovations

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2021

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vol. 4

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issue 1

11-20

EN

INTRODUCTION: Bleeding into the gastrointestinal tract in the prehospital setting is often a cause of a life-threatening condition. The vast majority of cases (80%) involve bleeding from the upper gastrointestinal tract and the mortality reaches even 14% of cases. It is then necessary to quickly diagnose and direct the patient for hospitalisation as the most effective treatment in the endoscopic therapy. The study aimed to analyse the profile of the patient referred to a hospital by a primary healthcare physician with suspicion and/or diagnosis of bleeding from the gastrointestinal tract. MATERIAL AND METHODS: The authors attempted to assess the initial laboratory results of critical parameters (RBC, HGB, HCT and PLT) of patients admitted on an emergency basis in 2017-2020 to the municipal hospital in Siedlce, Poland. The total number of patients with bleeding symptoms referred by a primary healthcare physician was 843. The inclusion procedure included patients referred on an emergency basis only (n=56). The statistical analysis was conducted by means of the Shapiro–Wilk test of normal distribution, Spearman's rho correlation and Chi-Square Tests of Independence. All results were regarded as significant at p < 0.05. RESULTS: The study included 32 males and 24 females referred in 60.71% of cases with the ICD-10 diagnosis of K92.2. The mean age of the patients was 65.02 years (SD±14.69). The mean hospitalisation time was 5.11 days (SD±12.14), both in males and females. The average blood test results in males were as follows: RBC: 3.28 106/μL; HGB: 9.26 g/dL; HCT: 27.94%; PLT: 229.13 103/μL, while in females: RBC: 3.26 106/μL; HGB: 9.76 g/dL; HCT: 29.12%; PLT: 240.33 103/μL. Therapy with packed red blood cells was significantly dependent on the level of RBC (p=0.000), HGB (p=0.001) and HCT (p=0.000). However, it was not dependent on PLT (p=0.141). A similar tendency was shown in the correlation of plasma therapy with critical values of selected laboratory tests (RBC: p=0,000; HGB: p=0.021; HCT: p=0.005; PLT: p=0.116). CONCLUSIONS:The hospitalisation of patients from the study group concerned mostly to older males, whose laboratory test results were usually much below the normal limits. Patients referred to hospital on an emergency basis usually warrant therapy related to deep anaemia. Despite a high survival rate, educational programmes aiming at early diagnosis of symptoms and implementation of diagnostics for bleeding from the gastrointestinal tract are to be considered.

PL

WSTĘP: Krwawienia do przewodu pokarmowego w warunkach przedszpitalnych niejednokrotnie są przyczyną wystąpienia stanu zagrożenia życia. Zdecydowana większość przypadków (80%) dotyczy krwawienia z górnego odcinka przewodu pokarmowego, a śmiertelność wynosi wówczas nawet do 14% przypadków. Niezbędne jest wówczas szybkie rozpoznanie i skierowanie pacjenta na hospitalizację, gdyż najskuteczniejszym leczeniem jest terapia endoskopowa. Celem badania była analiza profilu pacjenta skierowanego do szpitala przez lekarza pierwszego kontaktu z podejrzeniem i/lub rozpoznaniem krwawienia z przewodu pokarmowego. MATERIAŁ I METODY: Autorzy podjęli próbę oceny wyjściowych wyników laboratoryjnych parametrów krytycznych (RBC, HGB, HCT, PLT) pacjentów przyjętych w trybie pilnym w latach 2017-2020 do szpitala miejskiego w Siedlcach, Polska. Łączna liczba chorych skierowanych przez lekarza pierwszego kontaktu z objawami krwawienia wynosiła 843. Procedura włączenia uwzględniała pacjentów skierowanych jedynie w trybie pilnym (n=56). Do opracowania statystycznego wykorzystano test normalności rozkładu zmiennych Shapiro-Wilka, korelację rho-Spearmana oraz testy niezależności Chi kwadrat. Wszystkie wyniki uznano za istotne przy p < 0,05. WYNIKI: Badaniem objęto 32 mężczyzn oraz 24 kobiety, kierowanych w 60,71% przypadkach z rozpoznaniem ICD-10: K92.2. Średnia wieku chorych wynosiła 65,02 lat (SD±14,69). Średnia długość hospitalizacji zarówno u kobiet jak i u mężczyzn wyniosła 5,11 dnia (SD±12,14). Wyniki krwi mężczyzn wynosiły średnio dla RBC: 3,28 106/µl; HGB: 9,26 g/dl; HCT: 27,94%; PLT: 229,13 103/µl, zaś u kobiet RBC: 3,26 106/µl; HGB: 9,76 g/dl; HCT: 29,12%; PLT: 240,33 103/µl. Terapia koncentratami krwinek czerwonych była istotnie zależna od wartości RBC (p=0,000), HGB (p=0,001) i HCT (p=0,000). Nie była jednak zależna od PLT (p=0,141). Podobną tendencję wykazała korelacja terapii osoczem z krytycznymi wartościami wybranych badań laboratoryjnych (RBC: p=0,000; HGB: p=0,021; HCT: p=0,005; PLT: p=0,116). WNIOSKI: Hospitalizacja pacjentów z grupy badanej dotyczyła przeważnie osób starszych płci męskiej, u których wyniki badań laboratoryjnych były zazwyczaj znacznie poniżej dolnej granic norm. Pacjenci kierowani do szpitala w trybie pilnym wymagają zazwyczaj terapii związanej z głęboką niedokrwistością. Pomimo wysokiego współczynnika przeżywalności należy rozważyć wdrożenie programów edukacyjnych mających na celu wcześniejsze rozpoznawanie objawów i wdrożenie diagnostyki w kierunku krwawienia z przewodu pokarmowego.

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A brief analysis of patients suffering from stomach or duodenal ulcers in Almaty hospital №1

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Aryzbekova A., Juszkiewicz K. T., Burgess D. E., Polski A., Poleszak E.

Current Issues in Pharmacy and Medical Sciences

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2015

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vol. 28

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issue 4

241-243

EN

Peptic ulcers are a serious problem worldwide, and affect about 4 million people each year. Their etiology is connected with the presence of Helicobacter pylori, the act of smoking, drinking alcohol, being stress, and taking excessively nonsteroidal anti-inflammatory drugs, as well as steroids. The most common symptoms are abdominal pain, nausea, chest pain and fatigue, while less frequent symptoms include vomiting and weight loss. Helicobacter pylori is responsible for about 80% of gastric and 90% of duodenal ulcer cases. In this work, an analysis is made of a correlation between stomach or duodenal ulcer and gender, residence and number of patients hospitalized in the Almaty hospital №1, from 2009-2012, in order to learn about trends in the incidence of these diseases in Kazakhstan. A total number of 950 patients with stomach and duodenal ulcers, in 2009-2012, were questioned. The patient’s residence, gender and stomach or duodenal ulcer problem were taken into account in the study. The result of this work reveals that the largest amount of hospitalized patients suffering from stomach or duodenal ulcers came from urban areas. Moreover, more women than men suffered from peptic ulcers. Furthermore, the number of patients admitted to the hospital due to duodenal ulcers did not show any variation throughout the study. However, the least number of patients suffering from gastric ulcers was noticed in December 2009, and the greatest was in October and November 2011. The obtained data show that ulcers are a serious problem in Kazakhstan.

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Characterizing Subjective Noisiness in Hospital Lobbies

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Chen C.-Y.

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4

A 15-year regional emergency department study of youth sport and recreational injuries

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Romanick M. A., Schuch T., Goodwin B. J., Hanson C., Caine D. J.

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EN

Purpose The aim of this study was to determine frequency and distribution of sports- and recreation-related injuries (SRIs) affecting children and adolescents who visited a northern tier regional medical center emergency department during a 15-year period. Material and methods A descriptive epidemiologic design was employed to retrospectively examine age, gender, month and year of injury, location of injury, sport/recreational activity, mechanism of injury, type and severity of injury, hospital admission and length of stay. Frequency of reported injuries were compared in categories of single factors using Chi-square tests of homogeneity. The impact of risk factors – gender, age class, and sport/activity – on incidence ratios were analyzed via Poisson regression. All statistical analyses were run in R. Results Findings heretofore unreported or inconsistent with previous emergency department (ED) studies include a peak injury occurrence of SRIs during September; a preponderance of head/neck injuries and fractures and a higher percent of admitted patients; frequent occurrence of ice hockey injuries; increased severity of injury during ages 10-14; and a trend during 2000-2014 showing increased injury rate of various types of recreational injuries. Findings consistent with previous ED studies included variable distribution of injuries by age, gender and sport/activity; increased frequency of SRIs during ages 12-15 years and during the warmer months of the year; and trends of increased frequency of SRIs affecting females, increased injury rate of closed head injuries, and decreased occurrence of bicycle injuries during the study period. Further to these findings, several suggestions are made to inform and guide local injury prevention efforts and further research. Conclusions Our study results provide information on a region-specific occurrence and distribution of SRIs in a northern tier hospital catchment area that can be valuable to guide regional injury prevention efforts and further research to evaluate specific patterns identified and success of prevention efforts.

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OPINIA PIELĘGNIAREK NA TEMAT PRACY OPIEKUNÓW MEDYCZNYCH ZATRUDNIONYCH W SZPITALACH I ZAKŁADACH OPIEKUŃCZO-LECZNICZYCH

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Rzewnicka A., Kobos E.

Long-Term Care Nursing

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2019

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vol. 4

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issue 2

5-15

EN

Abstract The presence of medical caregivers in wards should make the work run more efficiently and increase the quality of patient care. Aim The analysis of nurses’ opinions about the work of medical caregivers employed in hospitals and health care centers. Material and methods The study included 50 nurses employed in hospitals and 50 working in health care centres. An original ques¬tionnaire was used to collect the research material. Results Most nurses agreed that medical caregivers should be responsible for their activities (hospital nurses: M = 4.68). Nurses working in hospitals expressed opinion that the presence of a medical caregiver is an advan¬tage. Nurses employed in healthcare centres were much more insecure about their professional position under the new circumstances. Conclusions In the opinion of the nurses, the employment of a medical caregiver is a real support for them, and therefore this is a profession of the future, in which the state should invest. Nursing staff do not have sufficient knowledge about the professional competence of medical caregivers.

PL

Wstęp Obecność opiekunów medycznych na oddziałach powinna spowodować, że praca będzie przebiegać tam sprawniej, a jakość opieki nad pacjentem wzrośnie. Cel pracy Analiza opinii pielęgniarek na temat pracy opiekunów medycznych zatrudnionych w szpitalach i zakładach opiekuńczo-leczniczych. Materiał i metody W badaniu udział wzięło 50 pielęgniarek pracujących w szpitalu i 50 pracujących w ZOL-u. Do zebrania materiału badawczego wykorzystano autorski kwestionariusz ankiety. Wyniki Najwięcej pielęgniarek zgodziło się z opinią, że opiekunowie medyczni powinni ponosić odpowiedzial-ność za wykonywane przez siebie czynności (pielęgniarki szpitala: M=4,68). Opinię, żeobecność opieku-na medycznego w oddziale jest atutem wyraziły pielęgniarki pracujące w szpitalu. Istotnie większą obawę o stanowisko pracy pielęgniarki w związku z zatrudnianiem opiekunów medycznych miały w pielęgniarki zatrudnione w ZOL-u. Wnioski W opinii pielęgniarek zawód opiekun medyczny jest zawodem z przyszłością, w który państwo powin¬no inwestować, obecność opiekuna medycznego stanowi realne wsparcie dla pielęgniarki. Personel pielęgniarski nie posiada wystarczającej wiedzy na temat kompetencji zawodowych opieku¬nów medycznych.

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Guidelines for the management of surgical departments in non-uniform hospitals during the COVID-19 pandemic

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Mitura K., Myśliwiec P., Rogula W., Solecki M., Furtak J. P., Kazanowski M., Kłęk S., Nowakowski M., Pędziwiatr M., Zawadzki M., Wallner G., Sobocki J.

Polish Journal of Surgery

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2020

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vol. 92(2)

42-53

EN

In the last several weeks we have been witnessing the exponentially progressing pandemic SARS-CoV-2 coronavirus. As the number of people infected with SARS-CoV2 escalates, the problem of surgical management of patients requiring urgent surgery is increasing. Patients infected with SARS-CoV2 virus but with negative test results will appear in general hospitals and may pose a risk to other patients and hospital staff. Health care workers constitutes nearly 17% of infected population in Poland, therefore early identification of infected people becomes a priority to protect human resources and to ensure continuity of the access to a surgical care. Both surgical operations, and endoscopic procedures are considered as interventions with an increased risk of infection. Therefore, determining the algorithm becomes crucial for qualifying patients for surgical treatment, but also to stratify the risk of personnel being infected during surgery and to adequately protect staff. Each hospital should be logistically prepared for the need to perform urgent surgery on a patient with suspected or confirmed infection, including personal protective equipment. Limited availability of the equipment, working under pressure and staff shortages in addition to a highly contagious pathogen necessitate a pragmatic management of human resources in health care. Instant synchronized action is needed, and clear uniform guidelines are essential for the healthcare system to provide citizens with the necessary surgical care while protecting both patients, and staff. This document presents current recommendations regarding surgery during the COVID-19 pandemic in Poland.

Refine search results

Course of hospitalization of patients referred on an emergency basis due to bleeding into the gastrointestinal tract.

A brief analysis of patients suffering from stomach or duodenal ulcers in Almaty hospital №1

Characterizing Subjective Noisiness in Hospital Lobbies

A 15-year regional emergency department study of youth sport and recreational injuries

OPINIA PIELĘGNIAREK NA TEMAT PRACY OPIEKUNÓW MEDYCZNYCH ZATRUDNIONYCH W SZPITALACH I ZAKŁADACH OPIEKUŃCZO-LECZNICZYCH

Guidelines for the management of surgical departments in non-uniform hospitals during the COVID-19 pandemic