The concept of the mathematical model for the prediction of recurrence of acute gastroduodenal bleeding
DOI:
https://doi.org/10.11603/2414-4533.2022.4.13604Keywords:
acute gastroduodenal bleeding, prognostic model of the probability of recurrence of gastroduodenal bleeding, peptic ulcer disease of the stomach and duodenumAbstract
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.
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