Abstract
Backgroundacute upper gastrointestinal bleeding (UGIB) is a common medical condition that results in substantial morbidity, mortality, and medical care cost. The mortality rate for patients with acute upper gastrointestinal (GI) bleeding is 5–10%, and it has not changed much since 1945, despite the development in medicines, endoscopy, intensive care units (ICU), and surgical management. We conduct this study to observe some of the factors that predict death in these patients. Materials and methodsThe Study was conducted at the Internal Medicine Department, Digestive Division, Aleppo University Hospital, between July 2018 and June 2020. The study included all patients with acute upper GI bleeding who were admitted to the digestive division during the study period, or who were admitted by other departments requesting an upper GI endoscopy. ResultsThis study involved 234 patients, 137 males (58.55%), 97 females (41.45%).The patients’ ages ranged between 17 and 81 years old, and the mean age value ± standard deviation was 57.15 ± 22.89 years old.The number of deaths reached 22, at a rate of 9.40%, 14 male deaths (10.22%), 8 female deaths (8.25%). Conclusionsin this study we found a moderate inverse relationship between the hemoglobin value at admission and the incidence of death; the lower the hemoglobin value at admission, the higher the probability of patient's death. Also, there is a very significant direct relationship between the number of blood units transfused and the incidence of death, noting that all patients who died had received blood transfusions. Finally, we found a moderate inverse relationship between the arterial blood pressure value at admission and the incidence of death.
Highlights
Acute upper gastrointestinal (GI) bleeding is one of the most com mon complaints that prompt a visit to the emergency room and an admission into hospital
The study was conducted at the Internal Medicine Department, Aleppo University Hospital, between July 2018 and June 2020, and included patients who were admitted to the gastroenterology division during the study period due to acute upper GI bleeding, and the patients with severe upper gastrointestinal bleeding during hospitalization for other reasons; the fasting time was at least 12–24 h before the upper GI endoscopy
All patients with acute upper GI bleeding who were admitted to the GI division during the study period, or referred by other departments requesting an upper GI endoscopy for them
Summary
Acute upper gastrointestinal (GI) bleeding is one of the most com mon complaints that prompt a visit to the emergency room and an admission into hospital. Patients with acute upper GI bleeding may present with one or multiple symptoms, including hematemesis (vom iting of blood or coffee-ground-like material) and/or melena (black, tarry stools) [1]. We conduct this research to observe some of the factors that predict death in patients with acute upper GI bleeding. The initial evaluation should include the history, physical exami nation, laboratory tests. The primary goal of the evaluation is to determine the severity and the location of the bleeding. It’s necessary to assess the risk of bleeding; coagulopathy in affected patients should be corrected by transferring fresh frozen plasma
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