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Upper Gastrointestinal Bleeding: A Retrospective, Single-Center Experience on the Role of Endoscopy and Outcomes
Ali M Someili1, Sarah Jaber Mobarki2, Razan Hamoud Moafa2
1Department of Internal Medicine, Faculty of Medicine, Jazan University, Saudi Arabia.
Insights
Timely endoscopy and effective treatments significantly improve outcomes for upper gastrointestinal bleeding (UGIB). Early identification of high-risk patients is crucial for reducing rebleeding and mortality rates in UGIB cases.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Background:
- Upper gastrointestinal bleeding (UGIB) is a common and potentially fatal medical emergency.
- This study investigates UGIB at King Fahad Central Hospital in Jazan, Saudi Arabia.
Purpose of the Study:
- To determine the frequency, causes, and outcomes of UGIB.
- To evaluate the efficacy of endoscopic treatment for UGIB.
Main Methods:
- Retrospective study of 483 hospitalized UGIB patients from January 2017 to December 2023.
- Analysis of sociodemographic data, clinical history, endoscopic findings, and treatment outcomes.
- Statistical analysis including descriptive and inferential approaches.
Main Results:
- Esophageal varices (52.2%) and duodenal ulcers (21.7%) were the most frequent endoscopic findings.
- Endoscopy within 24 hours was performed in 54.2% of patients.
- Rebleeding occurred in 7% with a 6% mortality rate; shock, renal disease, and transfusion needs were associated with rebleeding.
Conclusions:
- Prompt endoscopy and appropriate treatment significantly improve UGIB outcomes.
- Identifying high-risk patients and acting swiftly are critical for reducing rebleeding and mortality.
Background:
Upper gastrointestinal bleeding (UGIB) is a common and potentially fatal medical emergency. This study aimed to investigate the frequency, causes, outcomes, and efficacy of endoscopy in the treatment of UGIB at King Fahad Central Hospital in Jazan, Saudi Arabia.
Methods:
Between January 2017 and December 2023, a retrospective study was performed including all hospitalized patients with UGIB. This research investigated sociodemographic characteristics, clinical history, endoscopic findings, treatment options, and results using statistical analysis, which included both descriptive and inferential approaches.
Results:
The study included 483 patients (of which 74.1% men), with a mean age of 53.9 ± 19.5 years. Hematemesis was observed in 67.5% of the patients, whereas melena occurred in 49.7% of the cases. Two-hundred sixty-two (54.2%) patients underwent endoscopy within the first 24 h from presentation. The most frequent endoscopic findings were esophageal varices (52.2%) and duodenal ulcers (21.7%). Bandings accounted for 48.0% of all endoscopic procedures, whereas 36.9% of the patients received epinephrine injections along with endoclips. Medical therapy mostly consisted of a mix of proton pump inhibitors (PPIs) and octreotide. A significant minority (43.5%) of the patients stayed in the hospital for 1 - 3 days, while 59.6% did not need blood transfusions. During the first 3 days, 7% of patients experienced rebleeding, with a 6% mortality rate. Using multivariate regression analysis, rebleeding was strongly associated with initial presentation with shock (P < 0.001), renal disease (P = 0.01), and increased transfusion requirement (P = 0.001). Mortality was strongly associated with steroid usage (P = 0.007), increasing transfusion requirements (P < 0.0001), and rebleeding (P = 0.002).
Conclusions:
Timely endoscopy and proper treatment dramatically improved UGIB results. Identifying those who are at high risk and acting swiftly is a critical step in reducing the likelihood of recurrent bleeding and fatality.
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