Retrospective evaluation of patients with non-varicose upper gastrointestinal bleeding

Abstract

Upper gastrointestinal tract (GIS) bleeding refers to any bleeding originates from the area from upper esophagus to the proximal of the treitz ligament. It has a wide range of clinical manifestations ranging from hypovolemic shock to death. Bleeding from peptic ulcer (PU) is one of the major cause of upper GIS bleeding. Despite improvements in therapeutic endoscopy and angiography, gastrointestinal bleeding is still an important source of morbidity and mortality. Although approximately 80-85% of upper GIS bleeding stops spontaneously, supportive treatment is required. In this study, we aimed to determine the clinical, laboratory and demographic characteristics of patients with upper GIS bleeding and their relationship with major scoring systems. Two hundred thirteen patients over 18 years old that were admitted to Canakkale Onsekiz Mart University Training and Research Hospital between January 2016 and March 2020 with a diagnosis of non-variceal GIS bleeding were retrospectively enrolled to this study. Age, gender, blood group, comorbid conditions, endoscopic findings, laboratory values and medications were recorded for each patient. Prognostic scorings were calculated for each patient. The mean age of patients was 68.67±14.8 years (Male/Female: 156/57). In overall, 90.7% of patients were discharged and 7.5% of patients were transferred to intensive care unit. The mortality rate was 1.8%. Endoscopic evaluation revealed that 31.9% of patients had duodenal ulcer and 19.2% of patients had gastric ulcer. Medical treatment was applied to 84.8% of patients and 13.4% of patients received endoscopic treatments. Length of stay was significantly correlated with Rockall and Glasgow Blatchford scores. This study revealed that age, comorbid conditions and prior drug history were related to predisposition to GIS bleeding. Early diagnosis and intervention might reduce the mortality in these patients. Despite early endoscopic interventions and the improvements in endoscopic techniques GIS bleeding still associated with increased rates of morbidity and mortality.