Abstract
The most common cause of acute nonvariceal bleeding from the upper gastrointestinal tract (GIT) is ulcerative lesions of the stomach and duodenum. The aim of the present study was to investigate the structure of mortality in acute ulcerative gastroduodenal bleeding (AUGDB) and the influence of concomitant pathology, as well as to evaluate the possibilities of prognostic systems for determining the risk of lethal outcome. The study included 374 patients, 77 (20.6%) of them died, 12 (15.6%) patients had recurrence of ulcer bleeding. The risk factors for AUGDB include severe degree of blood loss with a change in shock index (SI) >0.8 in comorbid patients, multiple gastric and duodenal ulcer defects. A separate risk factor is an episode of AUGDB during inpatient treatment as a complication of the underlying disease. Rockall, Glasgow-Blatchford and PNED scales can be used to predict the lethal outcome, with the best results demonstrated by the PNED system: sensitivity 84.4% and specificity 77.4%.
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