Evaluation of 364 Cases With Non-Variceal Gastrointestinal System Bleeding

Abstract

Objective: In the present study, we aimed to determine the etiologic and risk factors, treatment modalities and mortality rate of Non-Variceal Gastrointestinal System Bleeding (NVUGISB) cases. Material and Methods: 364 cases with NVUGISB who were referred to the Adana Numune Training Hospital, Emergency Department, between January 01 2010 and January 01 2011 and examined by endoscopy in the Gastroenterolgy Department were assessed retrospectively. Demographical characteristics, etiology, risk factors, treatment modalities and mortality were determined. Results:The mean age of the 364 patients was 60.3±18.6) (18-96) years, of whom 237 (65.1%) were male and 127 (%) female. Of the patients, 136 (37.3%) were smokers, 18 (4.9%) drank alcohol, 96 (26.3%) had used acetyl salicylic acid (ASA), 63 (17.3%) had used non-steroidal anti-inflammatory drug (NSAID) and 20 (5.5%) had used anticoagulant agents (17 patients were using NSAID at the same time). When the co-morbid diseases had been evaluated; hypertension (121 patients, 33.2%), coronary artery disease (87 patients, 23.8%), daibetes mellitus (52 patients, 14.2%), cerebrovascular accident history (33 patients, 9%), and chronic obsturictive lung disease (14 patients, 3.8%) were determined. The first three most common causes of bleeding detected by endoscopy were duodenal ulcer 120 (33%), gastric ulcer 90 (24.7%) and erosive bulbitis 37 (10.2%). Of all patients, 337 (92.6%) responded to medical therapy whereas 7 (1.9%) cases required surgical intervention. Twenty (5.4%) patients died. Conclusion: Duodenal ulcer was found as the most common cause of NVU-GISB in this study. Bleeding is seen in the elderly more commonly and advanced age, co-morbid diseases and recurrent bleeding increase the mortality. (JAEM 2011; 10: 165-70

Predictors of Emergency Blood Transfusion in Esophageal Variceal Bleeding

“…Because of the lack of gastroenterology units in hospitals, it is usually hard to transfer these patients to suitable clinics. Correct and prompt blood transfusion can decrease the mortality of OVB (1)(2)(3). The indications of blood transfusion in OVB cases are the same as in other bleeding patients.…”

“…We have not found any studies on the predictors of immediate blood transfusion need in OVB patients in the literature. The studies on the subject are usually on predictive factors that influence 6-week survival (1)(2)(3).…”