Clinical outcomes of nonvariceal upper gastrointestinal bleeding in Kosova

Abstract

Background/Aims: The aim was to determine the sociodemographic and etiologic factors, endoscopic accuracy, treatment efficiency and clinical outcome of patients with nonvariceal upper gastrointestinal system bleeding in Kosova. Materials and Methods: We retrospectively evaluated patients who had applied to our Gastroenterology Department between January 2006 and December 2010. Results: There were 460 eligible cases with mean age 56.85+16.18 years, while male /female ratio was 2.71/1. The greatest occurrence was at age group of 60-69 years (27.1 %). The most common clinical symptom was melena (62.6%). Comorbid diseases were present in 57, 6% of the patients. The percentage of patients using acetylsalicylic acid and /or other non-steroidal anti-inflammatory drugs was 43.7%. Five point two percent were using anticoagulants. Peptic ulcer was the main cause of bleeding (82.2%) and most of them were Forrest III (41.6%). Endoscopic treatment was performed in 90 patients, primary hemostasis was achieved in 96.7% while rebleeding developed in 10% of these patients. The average length of hospital stay was 9.29+5.58 (1-35) days. Rebleeding was reported in 4.1% of all patients while the overall mortality rate was 5.7%. Conclusion: Age over 60 years, previous history of gastrointestinal bleeding, treatment with anticoagulants, low hemoglobin values at presentation(< 7g/dL), hematemesis, Forrest class, localization of lesion of bleeding, comorbidities, tachycardia, transfusion requirement > 2 unit, type of treatment and time of endoscopy were predictors of poor outcome in study present.

Clinical outcomes of non-variceal upper gastrointestinal bleeding and its relation to aspirin and anticoagulants.

“…In our studied patients groups, we noticed that the most common cause of NVUGIB by endoscopy was gastritis followed by esophageal erosions then GU, but all with no statistically significant difference. This was not in agreement with Telaku et al [58] who stated that the most common cause of NVUGIB was peptic ulcer.…”

Impact of Anemia on the Outcomes of Endoscopic Intervention in&nbsp;High-Risk NUGIB Patients

“…Hemoglobin level has been considered as an independent factor on the outcomes of NUGIB patients [1,[8][9][10][11][12]. However, the impact of hemoglobin level in high-risk patients underwent endoscopic intervention has not been clari ed.…”

“…There is no doubt about the bene ts of RBC transfusion for patients with severe UGIB improving the tissue oxygen supply in the circulation. A target threshold for red cell transfusion of 7-9 g/dl for severe UGIB patients (known as the restrictive transfusion strategy) is popularly recommended [9,17]. In our cohort study, most patients were treated following the recommendation of restriction transfusion [4,18], except for two older patients who were had RBC transfused at the condition of hemoglobin higher than 9 g/dL.…”

“…In clinical practice, lower hemoglobin levels in NUGIB patients are usually associated with severe clinical episodes, including mortality, recurrent hemorrhage and blood transfusion [1,[8][9][10][11][12]. In high-risk patients, anemia is relatively common, but the role of anemia on the prognosis of endoscopic intervention remains unclear.…”

Varis dışı üst gastrointestinal sistem kanamaları: Son 25 yılda ne değişti?

“…E:K oranı 2:1 olarak saptanmıştır. 18 ile 90 yaş aralığında değişen yaşlarda olan hastalarda ortanca yaş 64 olarak bulunmuştur (11)…”