Upper gastrointestinal bleeding: Causes and patient outcomes

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Research

Background:

• Upper gastrointestinal bleeding (UGIB) presents a substantial healthcare challenge, associated with significant morbidity and mortality.
• Understanding patient characteristics and outcomes is crucial for effective management.

Purpose of the Study:

• To delineate the clinical presentation, laboratory findings, and patient outcomes associated with UGIB.
• To identify key factors influencing patient outcomes in UGIB cases.

Main Methods:

• A retrospective analysis of electronic endoscopic reports from January 2006 to January 2015 at a tertiary care university hospital.
• Inclusion criteria encompassed patients undergoing gastroscopy for UGIB, with data collection on demographics, comorbidities, medications, symptoms, hemodynamic status, and laboratory results.
• Outcomes assessed included the need for blood products, intensive care unit (ICU) admission, rebleeding, and in-hospital mortality.

Main Results:

• The study included 259 patients (66.8% male, mean age 57.1 years), with 88.2% having at least one comorbidity.
• Nonvariceal sources accounted for 80.1% of UGIB causes. ICU admission was required for 15.5%, rebleeding occurred in 8.9%, and in-hospital mortality was 4.4%.
• No significant association was found between pre-endoscopic or total Rockall scores and rebleeding or ICU admission.

Conclusions:

• The predominant causes of UGIB in this cohort were nonvariceal.
• Rebleeding and mortality rates were comparable to those reported in international studies.
• The Rockall scoring system did not demonstrate predictive value for rebleeding or ICU admission in this population.