The Current Portrayal of Non-Variceal Upper Gastrointestinal Bleeding in a Portuguese Tertiary Center (original) (raw)
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Advances in Therapy, 2012
Introduction: Despite recent advances in endoscopic and pharmacological management, nonvariceal upper gastrointestinal bleeding (NVUGIB) is still associated with considerable mortality and morbidity that vary between countries. The European Survey of Nonvariceal Upper Gastrointestinal Bleeding (ENERGiB) reported clinical outcomes across Europe Spain, and Turkey) and evaluated management strategies in a "real-world" European setting. This article presents the differences in clinical management strategies among countries participating in ENERGiB.
Arquivos de Gastroenterologia
BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of ...
2019
Background: Upper gastrointestinal bleeding is a common medical emergency associated with significant morbidity and mortality. Aim of study: To determine the epidemiology and clinical profile of patients with upper gastrointestinal bleeding Methods: A total of 110 patients presenting with upper gastrointestinal bleeding were enrolled in this study. All the patients underwent esophagogastroduodenoscopy within 48 hours of admission. Distribution of patients according to demographic profile, clinical parameters, basic laboratory parameters and imaging were collected prospectively. Data were analysed applying standard statistical techniques. Statistical significance was considered when p <0.05. Result: Upper gastrointestinal bleeding was most common in 41-50 yrs age group (30%). It was more common in male population and people belonging to Hindu religion. Most common form of presentation is with both hematemesis and melena. Most common cause of UGIB among males was esophageal varices and peptic ulcer disease among females. Rockall score in 60% of patients was 2. The mortality in our study was 6%. Conclusion: The study showed that males in the age group 41-50 yrs, predominantly Hindus present commonly with upper gastrointestinal bleeding mostly due to esophageal varices.
Upper gastrointestinal bleeding: Five-year experience from one centre
Srpski arhiv za celokupno lekarstvo, 2008
Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI) bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stoppe...
Aetiological Profile of Patients Presenting with Upper Gastrointestinal Bleeding
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND In the recent years, the number of studies exclusively examining epidemiologic patterns of Upper Gastrointestinal Bleeding (UGIB) has been quite limited. However, most epidemiologic studies have shown a decrease in the incidence of all causes of upper gastrointestinal bleeding. Although, the incidences of peptic ulcers have remained unchanged. Gastrointestinal bleeding is a very common emergency accounting for 7-8% of acute medical admissions. UGIB is 4-5 times more common than the lower GI haemorrhage. Acute erosive gastritis is the most common cause followed by oesophageal varices, peptic ulcer and reflux oesophagitis. Upper GI bleed is more common in men than women (ratio 3:2) and the frequency increases with age. Hence, the present study was designed to study the aetiological profile of patients presenting with upper gastrointestinal bleeding. MATERIALS AND METHODS This one year cross-sectional study was conducted from January 2013 to December 2013. Sample size of 50 was considered. Patients aged 18 years and above presenting with upper gastrointestinal bleeding and who are fit for endoscopy were selected. Endoscopy was performed in all patients within 24 hrs. of admission and data was plotted in terms of rates, ratios and percentages and continuous data was expressed as mean ± standard deviation. RESULTS In the present study, most of the patients reported past history of liver disease and intake of NSAIDs and aspirins. In the present study, on clinical examination, most of the patients had pallor followed by tenderness. In the present study, the commonest diagnosis was cirrhosis of liver due to alcohol-induced with portal hypertension. CONCLUSION Upper GI endoscopy revealed varices as most common cause of upper gastrointestinal bleeding.
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2012
This observational, retrospective cohort study assessed outcomes of the current management strategies for nonvariceal upper gastrointestinal bleeding in several European countries (Belgium, Greece, Italy, Norway, Portugal, Spain, and Turkey) (NCT00797641; ENERGIB). Turkey contributed 23 sites to this study. Adult patients (≥18 years old) consecutively admitted to hospital and who underwent endoscopy for overt non-variceal upper gastrointestinal bleeding (hematemesis, melena or hematochezia, with other clinical/laboratory evidence of acute upper GI blood loss) were included in the study. Data were collected from patient medical records regarding bleeding continuation, re-bleeding, pharmacological treatment, surgery, and mortality during a 30-day follow-up period. A total of 423 patients (67.4% men; mean age: 57.8 ± 18.9 years) were enrolled in the Turkish study centers, of whom 96.2% were admitted to hospital with acute non-variceal upper gastrointestinal bleeding. At admission, the ...
United European Gastroenterology Journal, 2021
Objectives: Patients who develop upper gastrointestinal bleeding (UGIB) while in hospital appear to have a poor prognosis. Our study aims at analysing the difference in outcome between in-patients (IPs) and outpatients presenting with variceal and non-variceal UGIB. Methods: We conducted a multicentre prospective study by collecting data about variceal and non-variceal UGIB cases through 46 hospitals in France between November 2017 and October 2018. We then compared baseline demographic features, endoscopic findings and outcome between patients who developed variceal and non-variceal UGIB on admission (OPs) and those at least 24 h after hospitalisation (IPs). Our primary end-point was mortality and re-bleeding rates at 6 weeks of bleeding onset. Results: A total of 2498 UGIB cases were identified, of whom 634 (25.4%) occurred in IPs. IPs were older than OPs (72.5 vs. 67.2 years old, p < 0.001) and had a higher rate of comorbidities (38.9% vs. 26.6%, p < 0.0001). Their bleeding was more severe with a Rockall score of >5 present in 40.9% (vs. 30.3% in OPs, p < 0.0001). The 6week mortality rate was significantly higher in IPs when compared to OPs (21.7% vs. 8%, p < 0.0001). Prothrombin time <50% and rebleeding were the only independent predictors of mortality (p = 0.001 and 0.003, respectively). Six-week rebleeding occurred more frequently among IPs (18.6% vs. 14.4%, p = 0.015) and predictors # ANGH: Association Nationale des Hépato-Gastroentérologues des Hopitaux généraux This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Basrah Journal of Surgery, 2018
Upper gastrointestinal tract bleeding is a common emergency and life threatening condition. During the last three decades, many factors have been evolved that might change the incidence, age of presentation, site of bleeding and the outcome of patients with non variceal upper gastrointestinal tract bleeding. This study aimed to assess the profile and the mode of presentation of the patients with nonvariceal upper gastrointestinal tract bleeding and to assess the etiology and the effect of different factors (demographic, mode of presentation and the treatment options) on the patient's outcome. This observational prospective study was carried out from May 2008 to October 2014 in Basrah Teaching Hospital. All adult patients who were presented with non-variceal upper gastrointestinal tract bleeding were included. All the demographic, clinical and treatment modalities in addition to the mortality rate and complications data were collected and analyzed. A total of 238 patients with non-variceal upper gastrointestinal tract bleeding were included in this study, 161 (67.6 %) patients were males and 77 (32.3 %) were females. The mean age was 50.62±17.06. Hematemesis was the commonest presentation in 125 (52.5%) followed by melena in 81 (34.03%). Duodenal ulcer was the commonest cause in 99 (41.59%) patients followed by erosive gastritis in 37 (15.5%) patients. The most common treatment modality was the medical treatment used in 186 (78.15%) patients which was successful in 179 (96.23%) with relatively low complications and rebleeding rates. Interventional endoscopy was used for 40 (16.8%) and was successful in 38 (95%) with 2 (5%) patients developed rebleeding. Surgery was done for 12 (5.04%) patients and was successful in 8(66.6%) and it was associated with highest rate of mortality (33.3%). Concerning the factors that might affect the outcome, there was a statistically significant effect of mode of treatment (odd ratio 6.42, p=0.03) and smoking (odd ratio 5.86, p=0.047) on the rate of development of complications. The mode of treatment had a statistically significant effect on mortality rate (odd ratio 20.24 p=0.001). The use of aspirin and/or NSAID affects significantly the rebleeding rate (odd ratio 7.4 p=0.025). In conclusion, the profile of our patients with non-variceal upper gastrointestinal tract bleeding was not greatly different from that of surrounding Middle East countries. We found that peptic ulcer disease was the commonest cause for which medical treatment was the most successful mode of treatment. Among many known risk factors, the mode of treatment and smoking were the factors that increase the complication rate. The mode of treatment was the only factor that affects the mortality rate. Use of aspirin or non-steroidal anti-inflammatory drugs influenced the rebleeding rate.