Predictive Factors of Mortality From Nonvariceal Upper Gastrointestinal Hemorrhage: A Multicenter Study

Abstract

These results indicate that 30-day mortality for nonvariceal bleeding is low. Deaths occurred predominantly in elderly patients with severe comorbidities or those with failure of endoscopic intention to treatment.

Predictors of in-hospital mortality in patients with non-variceal upper gastrointestinal bleeding

“…The number of comorbidities was significantly higher in patients who died and it was an independent predictor of death (OR: 1.6; 95% CI: 1-2.5, p = 0.045). This finding is similar to that observed in other studies, particularly RUGBE and PNED studies (3,5,8). On the other hand, hypovolemic shock as cause of death was significantly higher in patients without comorbidities than in those with comorbidities (48 vs. 21%, p = 0.02).…”

“…Current evidence sug- gests that early administration of PPIs is the standard treatment of patients with NVUGB (20)(21)(22)(23)(24). The rebleeding rate observed in our patients (3.4%) was similar to that observed in the Italian PNED study (3.2%) and in other recent publications (17,18), but it was significantly lower than that reported in the Canadian RUGBE study (14.1%) (3,5,8). The divergence of our results from the ones of the Canadian study may be explained because a higher proportion of our patients received combined endoscopic therapy (adrenaline injection plus BICAP) than in the Canadian study; combined therapy has been shown to be superior to pharmacologic treatment for reduction of rebleeding in controlled trials (25)(26)(27).…”

“…Recent prospective studies have identified different predictors of mortality; it is worth noting that the use of proton pump inhibitors (PPIs) significantly reduces mortality in patients both with and without high risk stigmata of rebleeding. Moreover, the use of endoscopic treatment has been demonstrated to reduce mortality in greater proportion than drug treatment (3)(4)(5)(6). However, it has been shown that the risk factors, complications and mortality rates described in controlled trials are lower than those reported in patients who received their attention on "day-today conditions" in a tertiary care community hospital (7), which illustrates more accurately the actual conditions of medical care.…”

Outcomes and predictors of in-hospital mortality among cirrhotic patients with non-variceal upper gastrointestinal bleeding in upper Egypt

“…Predictors of in-hospital mortality among cirrhotic patients with NVUGIB in our study were bacterial infection during hospitalization, shock, early rebleeding, low serum albumin, low baseline hemoglobin, and endoscopic treatment, whereas the following predictors were observed in the non-cirrhotic patients: severity of a bleeding episode, functional class, in-hospital bleeding, number of comorbidities, and advanced age (2,12,21,24,25).…”

“…Upper gastrointestinal (GI) bleeding is a common lifethreatening condition with a reported mortality rate of 4%-15% in most studies (1)(2)(3)(4)(5). Upper GI bleeding is classified according to the presence of a variceal or nonvariceal source of bleeding.…”