The effect of permanent stress caused by the war in Ukraine on the condition of patients after portal esophageal bleeding
Authors:   National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Petrushenko V.V. , Grebeniuk D.I. ,   National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Buriak R.V. ,   National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Hrytsun Y.P. ,   National Pirogov Memorial Medical University, Vinnytsya, Ukraine, Palahniuk H.O. ,   National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Published: July 2023

Purpose - to assess the impact of permanent stress caused by the war in Ukraine on the condition of patients after portal esophageal bleeding. Materials and methods. The study included 37 patients with a confirmed diagnosis of liver cirrhosis complicated by portal hypertension and esophageal variceal bleeding. The Group 1 included patients who underwent endoscopic band ligation of bleeding varices and partial splenic artery embolization 1 month after the bleeding. The Group 2 included patients who underwent only endoscopic band ligation. Patients of the Groups 1 and 2 underwent all stages of the study before the start of the war in Ukraine. The Group 3 included patients who had a bleeding episode within 1 month before the start of the war. In dynamics, the levels of laboratory indicators of the functional state of the liver and the quality of life according to the SF-36 questionnaire of patients were evaluated. Results. In the Group 1, there was a reliable progressive improvement of all studied indicators over time. In the Group 2, there was a reliable improvement of all indicators in the period between the first and second visits, with their subsequent slight negative dynamics, but without statistical reliability. In the Group 3, the dynamics of changes in all studied laboratory indicators on the first four visits generally repeated that in the Group 2. On the fifth visit, the numerical values of almost all studied indicators were higher than the initial values, although the differences were not statistically significant. As for the quality of life, on the second visit there was a significant increase in the indicators of the physical component of health and a decrease in the indicators of the psychological component of health. Subsequently, a decrease in the values of both indicators in comparison with the values on the second visit was observed. On the fifth visit, there was an increase in indicators of the psychological component of health. Conclusions. The stay of patients after portal esophageal bleeding in a state of permanent stress leads to the deterioration of the psychological component of health from the very beginning of the action of stressful factors, followed by a gradual decrease in the physical component of health. The cumulative effect of permanent stress leads to the objectification of changes in the physical condition of such patients, which is manifested by the deterioration of indicators of the functional state of the liver. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.