Upper Gastrointestinal Bleeding: A Retrospective, Single-Center Experience on the Role of Endoscopy and Outcomes.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Journal of clinical medicine research Pub Date : 2025-01-01 Epub Date: 2025-01-14 DOI:10.14740/jocmr6134
Ali M Someili, Sarah Jaber Mobarki, Razan Hamoud Moafa, Leena Nageeb Alsury, Roaa Hassan Shadad, Shroog Mohammed Fathi, Amnah Hussain Hamrani, Afnan Mohammed Darisi, Amal H Mohamed, Sameer Alqassmi, Mostafa Mohrag, Mohammed Abdulrasak
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引用次数: 0

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common and potentially fatal medical emergency. This study aimed to investigate the frequency, causes, outcomes, and efficacy of endoscopy in the treatment of UGIB at King Fahad Central Hospital in Jazan, Saudi Arabia.

Methods: Between January 2017 and December 2023, a retrospective study was performed including all hospitalized patients with UGIB. This research investigated sociodemographic characteristics, clinical history, endoscopic findings, treatment options, and results using statistical analysis, which included both descriptive and inferential approaches.

Results: The study included 483 patients (of which 74.1% men), with a mean age of 53.9 ± 19.5 years. Hematemesis was observed in 67.5% of the patients, whereas melena occurred in 49.7% of the cases. Two-hundred sixty-two (54.2%) patients underwent endoscopy within the first 24 h from presentation. The most frequent endoscopic findings were esophageal varices (52.2%) and duodenal ulcers (21.7%). Bandings accounted for 48.0% of all endoscopic procedures, whereas 36.9% of the patients received epinephrine injections along with endoclips. Medical therapy mostly consisted of a mix of proton pump inhibitors (PPIs) and octreotide. A significant minority (43.5%) of the patients stayed in the hospital for 1 - 3 days, while 59.6% did not need blood transfusions. During the first 3 days, 7% of patients experienced rebleeding, with a 6% mortality rate. Using multivariate regression analysis, rebleeding was strongly associated with initial presentation with shock (P < 0.001), renal disease (P = 0.01), and increased transfusion requirement (P = 0.001). Mortality was strongly associated with steroid usage (P = 0.007), increasing transfusion requirements (P < 0.0001), and rebleeding (P = 0.002).

Conclusions: Timely endoscopy and proper treatment dramatically improved UGIB results. Identifying those who are at high risk and acting swiftly is a critical step in reducing the likelihood of recurrent bleeding and fatality.

上消化道出血:回顾,单中心经验对内镜的作用和结果。
背景:上消化道出血(UGIB)是一种常见且可能致命的急症。本研究旨在调查沙特阿拉伯吉赞法赫德国王中心医院内窥镜治疗UGIB的频率、原因、结果和疗效。方法:2017年1月至2023年12月,对所有UGIB住院患者进行回顾性研究。本研究调查了社会人口学特征、临床病史、内窥镜检查结果、治疗方案和使用统计分析的结果,其中包括描述性和推断性方法。结果:纳入483例患者,其中男性74.1%,平均年龄53.9±19.5岁。67.5%的患者出现呕血,49.7%的患者出现黑黑。262例(54.2%)患者在发病后24小时内接受了内窥镜检查。最常见的内镜表现为食管静脉曲张(52.2%)和十二指肠溃疡(21.7%)。绑带占所有内镜手术的48.0%,而36.9%的患者在接受内窥镜手术的同时接受肾上腺素注射。药物治疗主要包括质子泵抑制剂(PPIs)和奥曲肽的混合。43.5%的患者住院时间为1 ~ 3天,59.6%的患者不需要输血。在前3天,7%的患者出现再出血,死亡率为6%。通过多变量回归分析,再出血与最初表现为休克(P < 0.001)、肾脏疾病(P = 0.01)和输血需求增加(P = 0.001)密切相关。死亡率与类固醇使用(P = 0.007)、输血需求增加(P < 0.0001)和再出血(P = 0.002)密切相关。结论:及时内镜检查和适当治疗可显著改善UGIB结果。确定高危人群并迅速采取行动是减少复发性出血和死亡可能性的关键步骤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
5.10
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