The concept of the mathematical model for the prediction of recurrence of acute gastroduodenal bleeding

Authors

  • Ya. V. Kachanovskyi I. Horbachevsky Ternopil National Medical University
  • I. Ya. Dziubanovskyi I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2022.4.13604

Keywords:

acute gastroduodenal bleeding, prognostic model of the probability of recurrence of gastroduodenal bleeding, peptic ulcer disease of the stomach and duodenum

Abstract

The aim of the work: to develop a mathematical model for predicting the probability of recurrence of GGDC under the condition of chronic active gastroduodenal ulcer.

Materials and Methods. The endoscopic examination of 378 patients with chronic bleeding ulcers of the stomach and PPD according to the Forest classification was analyzed. There were 257 (67.98 %) male patients, 121 (32.02 %) female patients. The age of the examined patients ranged from 20 to 89 years. The distribution of patients according to the degree of previous blood loss was as follows: 102 (27.0 %) from the 1st stage, 156 (41.3 %) from the 2nd stage, 120 (31.7 %) from the 3rd stage. The distribution by type of blood activity is as follows: F IA – 27 people, F IB – 41, F IIA – 62, F IIB – 63, F IIC – 38, F III – 147 people. From Forest IA, IB, IIA, IIB, IIS there were 231 (61.11 %) seven who underwent endoscopic hemostasis (injection therapy or argon plasma coagulation). In 147 (38.89 %) hemostasis assistance was not performed due to the endoscopic pattern of bleeding activity according to Forest III.

The comorbidity index was evaluated according to Charlson M.E. and sang (1987). In the group of observed groups, the Charleston comorbidity index was equal to 3.07±0.61 points.

Results and Discussion. The research results established factors that have an influence on the probability of recurrence of GGDC, namely: endoscopic criteria according to Forrest, type of previous hemostasis, localization of ulcers, number of previous recurrences of gastroduodenal bleeding, volume of previous blood loss, gender, blood group according to the AB0(Rh) system , Charlson comorbidity index, age. After calculating the sensitivity and specificity of this mathematical model using the corresponding formulas, we found that its sensitivity is 78 % and its specificity is 70 %. On the basis of the obtained statistically significant prognostic relationships, a mathematical model for predicting the probability of recurrence of GGDC in patients with chronic active gastroduodenal ulcer is proposed, which will allow to prevent the development of repeated gastrointestinal bleeding as effectively as possible at all levels of medical care, and especially in the practice of a surgeon.

References

Fomin, P.D., Bereznytskyi, Ya.S., & Boiko, V.V. (2012). Udoskonaleni alhorytmy diahnostyky ta likuvannya hostroho pankreatytu: metodychni rekomendatsiyi [Improved algorithms for diagnosis and treatment of acute pancreatitis: methodical recommendations]. Kyiv [in Ukrainian].

Lin, H.Y., Weng, S.F., Lin, H.J., Hsu, C.C., Wang, J.J., Su, S.B., ... & Huang, C.C. (2015). Peptic ulcer disease in healthcare workers: a nationwide population-based cohort study. PLoS One, 10(8), e0135456.

Kim, J., Chung, H.S., Choi, M.K., Roh, Y.K., Yoo, H.J., Park, J.H., ... & Moon, S. (2019). Association between serum selenium level and the presence of diabetes mellitus: a meta-analysis of observational studies. Diabetes & Metabolism Journal, 43(4), 447-460.

Chen, Y.C., Ho, C.C., Yi, C.H., Liu, X.Z., Cheng, T.T., & Lam, C.F. (2017). Exendin-4, a glucagon-like peptide-1 analogue accelerates healing of chronic gastric ulcer in diabetic rats. PloS One, 12(11), e0187434.

Chi, T.Y., Zhu, H.M., & Zhang, M. (2018). Risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced gastrointestinal bleeding resulting on people over 60 years old in Beijing. Medicine, 97(18).

Yu, H., Dai, X.J., Zhang, H.B., Huang, Y.T., Ran, D.Z., Yang, Y., ... & Wu, L.P. (2017). Efficacy of two bariatric surgeries in type 2 diabetic patients with a body mass index of 25-27.5. Nan Fang yi ke da xue xue bao = Journal of Southern Medical University, 37(5), 693-697.

Peng, Y.L., Leu, H.B., Luo, J.C., Huang, C.C., Hou, M.C., Lin, H.C., & Lee, F.Y. (2013). Diabetes is an independent risk factor for peptic ulcer bleeding: A nationwide population-based cohort study. Journal of Gastroenterology and Hepatology, 28(8), 1295-1299.

Wu, S.C., Chen, W.T.L., Fang, C.W., Muo, C.H., Sung, F.C., & Hsu, C.Y. (2016). Association of vagus nerve severance and decreased risk of subsequent type 2 diabetes in peptic ulcer patients: An Asian population cohort study. Medicine, 95(49).

Wei, F., & Lin, X. (2016). Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis. The Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology, 27(4), 304-311.

Murata, A., Matsuda, S., Kuwabara, K., Ichimiya, Y., Fujino, Y., & Kubo, T. (2012). The influence of diabetes mellitus on short-term outcomes of patients with bleeding peptic ulcers. Yonsei Medical Journal, 53(4), 701-707.

Cho, K.S. Peptic ulcer. ILO Encyclopaedia of Occupational Health & Safety. Retrieved from: http://www.ilo.org/iloenc/part-i/digestive-system/item/250-peptic-ulcer.

Chou, L.P., Li, C.Y., & Hu, S.C. (2014). Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan. BMJ Open, 4(2), e004185.

Chen, K.Y., Yang, C.M., Lien, C.H., Chiou, H.Y., Lin, M.R., Chang, H.R., & Chiu, W.T. (2013). Burnout, job satisfaction, and medical malpractice among physicians. International Journal of Medical Sciences, 10(11), 1471-1478.

Chen, Y.T., Huang, C.C., Weng, S.F., Hsu, C.C., Wang, J.J., Lin, H.J., ... & Juan, C.W. (2015). Acute myocardial infarction: a comparison of the risk between physicians and the general population. BioMed Research International, 2015.

Yates, P.J., Benson, E.V., Harris, A., & Baron, R. (2012). An investigation of factors supporting the psychological health of staff in a UK emergency department. Emergency Medicine Journal, 29(7), 533-535.

Published

2022-12-29

How to Cite

Kachanovskyi, Y. V., & Dziubanovskyi, I. Y. (2022). The concept of the mathematical model for the prediction of recurrence of acute gastroduodenal bleeding. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 19–22. https://doi.org/10.11603/2414-4533.2022.4.13604

Issue

Section

ORIGINAL INVESTIGATIONS