Acute Upper Gastrointestinal Bleeding in Central Greece: The Role of Clinical and Endoscopic Variables in Bleeding Outcome

Abstract

The objectives of this work were to portray the incidence of upper gastrointestinal bleeding in central Greece and to define subsets at higher risk of poor outcome or death. Two hundred and sixty-four cases were recorded. The incidence was 116 per 100,000 per year (95% CI: 102-130). Re-bleeding was noted in 7.9% of patients. The case fatality was 7.2% and population mortality 8 per 100,000 per year (95% CI: 4-12). Independently significant risk factors for re-bleeding were stigmata of bleeding at endoscopy (OR: 3.11; 95% CI: 1.06-9.13, P = 0.04), smoking (OR: 3.39; 95% CI: 1.08-10.62, P = 0.03), and the use of anti-coagulant drugs (OR: 2.64; 95% CI: 1.00-7.13, P = 0.05), while the independently significant risk factor for death was re-bleeding (OR: 5.74; 95% CI: 1.40-23.52, P = 0.03). We conclude that patients with stigmata of bleeding at endoscopy and on anti-coagulant therapy should be under close surveillance because of the higher risk of re-bleeding. Smoking also increases the risk of re-bleeding. Patients with re-bleeding episodes must be managed intensively because of the higher risk of death.

Variceal bleeding in cirrhotic patients: What is the best prognostic score?

“…Acute upper gastrointestinal (GI) bleeding is a frequent cause of hospital emergency admissions worldwide (2). The causes of UGIB may be variceal (esophageal or gastric varices) or nonvariceal (erosive gastritis, gastric or duodenal ulcer, reflux esophagitis, etc.).…”

Varis dışı üst gastrointestinal sistem kanamalı hastaların demografik ve klinik özellikleri

“…1020 hastay› içeren ‹talyan çok merkezli çal›flmada mortalite oran› %4.5 oran›nda bulunmufl ve bu olgular›n %85'inde bir veya birden fazla ko-morbidite saptanm›flt›r. Otuz günlük tekrar kanama inisiyal endoskopik hemostazda baflar›s›zl›k ve ciddi ko-morbidite ile iliflkili bulunmufltur (13). Ko-morbidite ile mortalite aras›ndaki iliflki di¤er çal›flmalarda da gösteril-mifltir (14,15).…”

Mortality In Geriatric Patients With Upper Gastrointestinal Bleeding

“…Tüm 65 yaş üzeri hastalarda mortalite oranı %8,4 iken yaş gruplarına göre incelendiğinde 65-74 yaş arasında %5, 75-84 yaş arasında %6,5, 85 yaş ve üzerinde ise %29,6 olarak saptandı. Yunanistan'da yapılan bir çalışmada mortalite %7,2 olarak tespit edilmiştir (13). Bu çalışmada 60 yaş altı hastalarda mortalite %3,8 iken, 60 yaş üstü hastalarda mortalite %8,6 olarak bildirilmiştir (13).…”