Epidemiological Profile of Patients With Non-Variceal Upper Gastrointestinal Bleeding Secondary to Peptic Disease in a Tertiary Referral Brazilian Hospital

Abstract

BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%). CONCLUSION: Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.

Hypertonic dextrose spray as topical endoscopic hemostasis for non-variceal upper gastrointestinal bleeding

“…These drugs increase the risk of ulcers and bleeding since they cause gastric erosion and inhibition of platelet aggregation. 19 The observed male predominance was similar to what has been observed in some previous studies. [19][20][21] A possible explanation is gender-related differences in lifestyle, since cigarette smoking and alcohol consumption are more common in men.…”

Genetic Variants in PTGS1 and NOS3 Genes Increase the Risk of Upper Gastrointestinal Bleeding: A Case–Control Study

“…In this context, considering that UGIB is a digestive emergency associated with high morbidity (Quan et al, 2014) and seven out of every hundred patients admitted and underwent upper digestive endoscopy (UDE) in a tertiary hospital were diagnosed with UGIB (Forgerini et al, 2021c), studies have been assessing the influence of genetic variants on this risk, especially in LDA and NSAIDs users.…”

VNTR Polymorphism in Intron 4 of the eNOS Gene and the Risk of Gastrointestinal Bleeding: A Case-control Study

“…Ultimately, this study has strengths and limitations. This is the first time this type of study was performed in the more diverse Brazilian population, the cases were recruited during 46 months (a mean of four diagnoses of UGIB/month) [13], inclusion of only biologically unrelated participants in order to reduce possible biases, and data collection through faceto-face interviews including several confounding variables for UGIB. The limitations of this study are the non-conduct of the haplotype analyses of the T-786C, 4b/4a VNTR and Glu298Asp polymorphisms of NOS3 gene and the limited number of LDA/NSAIDs users.…”

“…Both participants were recruited from the same hospital complex and the inclusion and exclusion criteria for the participants of case and control groups are described in detail in our two previous studies [6,13].…”