Acute gastrointestinal bleeding cases presenting to the emergency department are associated with age, sex and seasonal and circadian factors

Lenzen, Henrike; Musmann, Eliane; Kottas, Martina; Schönemeier, B; Köhnlein, Thomas; Manns, Michael P.; Lankisch, Tim O.

doi:10.1097/meg.0000000000000752

Cited by 8 publications

(17 citation statements)

References 29 publications

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“…Szegin et al demonstrated a weak seasonal fluctuation in bleeding incidence for 336 patients [6]. A more recent study with 578 patients showed more bleeding events in winter and during nighttime [7]. Nomura et al were able to show an inverse relationship between incidence of hematemesis, temperature, and vapor pressure and a parallel relationship to atmospheric pressure in 441 patients [8].…”

Section: Introductionmentioning

confidence: 99%

A study on the correlation of gastrointestinal bleeding and meteorological factors – is there a weather condition for GI bleeding?

et al. 2019

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Aim We tried to identify a possible correlation between meteorological factors and the frequency of gastrointestinal bleeding (GIB). Methods We analyzed all endoscopic examinations performed because of suspected GIB from 2013 to 2016 at Jena University Hospital, Germany. Confirmed bleeding events were correlated with local meteorological data and meteorological season using multivariate analysis. Results Among a total of 35 522 examinations, we identified 5310 endoscopies performed for suspected GIB (61.5 % upper, 38.5 % lower endoscopies). In 35.5 %, GIB could be ascertained, gastroduodenal ulcers being the most frequent bleeding source. Of bleedings, 46.7 % merited an endoscopic intervention. Multivariate analysis did not show a correlation between meteorological factors and the total number of bleeding events. In subgroup analysis, lower ambient temperatures as well as pronounced changes in daily temperature were significantly associated with a higher rate of variceal hemorrhage (incidence rate ratio [IRR]: 0.961 for higher minimum temperature, p = 0.019; IRR: 1.119 per degree temperature change, p = 0.021), whereas ulcerative bleeding was associated with changes in air pressure (IRR: 1.031 per hPa, p = 0.010). Conclusions Our study does not support the correlation of meteorological conditions with the frequency of GIB per se. However, we found a statistically significant increase of variceal bleeding episodes along with lower ambient temperatures and pronounced changes in daily temperature. Patients at risk for variceal hemorrhage should be advised to avoid exposure to low temperatures, whenever possible. Ulcerative bleeding was significantly associated with changes in air pressure.

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Section: Introductionmentioning

confidence: 99%

A study on the correlation of gastrointestinal bleeding and meteorological factors – is there a weather condition for GI bleeding?

et al. 2019

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“…10 In foreign countries, Lenzen et al also have found that UGIB has seasonal and circadian distribution differences, and its incidence is increased in winter and night. 11 Through retrospective logistic regression analysis, Tahri et al also have found that esophagogastric variceal bleeding occurs most frequently in winter (OR = 3.2; 95% CI = 1.6–6.54), and stormy weather is also an independent factor, with (OR=13.4; 95% CI = 1.5–118.5). 12 A study that includes 348,958 patients hospitalized with esophagogastric variceal bleeding over the past decade in the USA also has reached a similar conclusion, that is, there are seasonal changes in the incidence and mortality of variceal bleeding.…”

Section: Discussionmentioning

confidence: 98%

Establishment and Evaluation of a Time Series Model for Predicting the Seasonality of Acute Upper Gastrointestinal Bleeding

Fu¹,

Xi²,

Zhang³

et al. 2021

IJGM

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We aimed to establish and evaluate a time series model for predicting the seasonality of acute upper gastrointestinal bleeding (UGIB). Methods: Patients with acute UGIB who were admitted to the Emergency Department and Gastrointestinal Endoscopy Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to December 2019 were enrolled in the present study. The incidence trend of UGIB was analyzed by seasonal decomposition method. Then, exponential smoothing model and autoregressive integrated moving average model (ARIMA) were used to establish the model and forecast, respectively. Results: Finally, the exponential smoothing model with better fitting and prediction effect was selected. The smooth R2 was 0.586, and the Ljung-Box Q (18) statistic value was 22.272 (P = 0.135). The incidence of UGIB had an obvious seasonal trend, with a peak in annual January and a seasonal factor of 140%. After that, the volatility had gradually declined, with a trough in August and a seasonal factor of 67.8%. Since then, it had gradually increased. Conclusion:The prediction effect of exponential smoothing model is better, which can provide prevention and treatment strategies for UGIB, and provide objective guidance for more medical staff in Emergency Department and Gastrointestinal Endoscopy Center during the peak period of UGIB.

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“…However, the number of the studies investigating the influence of the seasonal variation on UGB is few. In some studies, it has been claimed that especially cold climate conditions increase UGB for various reasons (5,7). Nonetheless, in most of these studies the authors concentrated rather on the influence of climate conditions on the number of cases and endoscopic findings.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to these risk factors, it has been suggested that seasonal variations can influence UGB. Some studies have shown a seasonal fluctuation in the incidence of UGB, but this seasonal pattern remains controversial (4,5). In fact, while some studies have revealed an increased incidence in winter and a decreased incidence in summer, others have shown no seasonal influence (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have shown a seasonal fluctuation in the incidence of UGB, but this seasonal pattern remains controversial (4,5). In fact, while some studies have revealed an increased incidence in winter and a decreased incidence in summer, others have shown no seasonal influence (4)(5)(6). In this study, it is investigated whether there is a relation between seasonal variation and the incidence of UGB, Glasgow-Blatchford risk scoring system and some clinical laboratory parameters.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Seasonal Variation on Upper Gastrointestinal System Bleeding in Emergency Department

Oğuzlar

Hatip

Coşkun

et al. 2019

Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi

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Özet Amaç: Birçok klinik değişken üst gastrointestinal sistem (GİS) kanamasında yüksek morbidite ve mortalite ile ilişkilendirilmiştir. Bu risk faktörlerine ek olarak, mevsimsel değişikliklerin üst GİS kanamasını etkileyebileceği öne sürülmektedir. Bu çalışma ile mevsimsel değişiklikler ile üst GİS kanamasının insidansı, Glasgow-Blactford risk skoru ve bazı klinik ve laboratuar değişkenler arasındaki ilişki araştırılmıştır. Materyal-Metot: Üst GİS kanama tanısıyla hastaneye yatırılan hastaların dosyaları tarandı. Yaş, cinsiyet, başvuru tarihi, başvurudaki laboratuar sonuçları, vital bulguları, Glasgow-Blacford skoru, yoğun bakım ihtiyacı, yatış süresi, eritrosit süspansiyonu ihtiyacı ve hasta sonlanımı kayıt edildi. Başka merkeze sevk edilen hastalar, yatışı süresinde üst GİS kanama tanısı dışlanan hastalar ve 18 yaş altı hastalar çalışma dışı bırakıldı. Bir yıllık süre kış, ilkbahar, yaz ve sonbahar olmak üzere 4 mevsime ayrıldı. Bulgular: Çalışmamıza 163 erkek, 108 kadın olmak üzere toplam 271 hasta dahil edildi. Yoğun bakıma yatan hasta sayısı 205, servise alınan hasta sayısı 66 idi. 187 hastaya eritrosit süspansiyonu uygulandığı, 35 hastanın ise öldüğü tespit edildi. Kan üre azotu, Glasgow-Blacford skoru, kalp hızı yüksekliği ile düşük sistolik ve diastolik kan basıncı değerleri yüksek mortalite ile ilişkili saptandı. Üst GİS kanamalı hasta sayısının özellikle mayıs ayında olmak üzere ilkbaharda arttığı, sonbaharda azaldığı saptandı. Mevsimler arasında klinik ve laboratuar bulgular açısından istatistiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: Üst GİS kanamalı hasta sayısının ilkbahar aylarında arttığı görülmektedir. Acil servis hekimleri bu aylarda üst GİS kanama açısından daha dikkatli olmalıdırlar. Ayrıca mevsimler arasında hiçbir klinik ve laboratuar bulgusu açısından anlamlı farklılık olmadığı görülmektedir. Anahtar kelimeler: Acil Servis, Mevsimsel Değişiklikler, Üst GİS Kanama. AbstractObjective: Multiple factors are known to be associated with a high risk of morbidity and mortality in Upper Gastrointestinal Bleeding (UGB). In addition to these risk factors, it has been suggested that seasonal variations can influence UGB. In this study, it is investigated whether there is a relation between seasonal variation and the incidence of UGB, Glasgow-Blatchford risk score and clinical and laboratory parameters. Material-Method:We retrospectively reviewed the records of the patients who were diagnosed and hospitalized with UGB. Age, gender, admission date, laboratory parameters, vital signs and Glasgow-Blatchford risk score at admission, intensive care unit admission, length of stay, erythrocyte suspension transfusion requirement and outcome were all documented. Patients who were referred to another hospital despite having diagnosed UGB, patients who were found to have been misdiagnosed while follow-up and patients under 18 years old were excluded. The 12 months of the year were divided into four seasons as winter, spring, summer and autumn. Results: We included 271 patients, of whom 163 were males an...

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Acute gastrointestinal bleeding cases presenting to the emergency department are associated with age, sex and seasonal and circadian factors

Cited by 8 publications

References 29 publications

A study on the correlation of gastrointestinal bleeding and meteorological factors – is there a weather condition for GI bleeding?

A study on the correlation of gastrointestinal bleeding and meteorological factors – is there a weather condition for GI bleeding?

Establishment and Evaluation of a Time Series Model for Predicting the Seasonality of Acute Upper Gastrointestinal Bleeding

Effects of Seasonal Variation on Upper Gastrointestinal System Bleeding in Emergency Department

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