CHANGING PATTERNS IN THE EPIDEMIOLOGY OF ACUTEGASTROINTESTINAL BLEEDING IN BRAZIL OVER THE LAST 12 YEARS.

Q2 Medicine

Arquivos de Gastroenterologia Pub Date : 2026-03-02 eCollection Date: 2026-01-01 DOI:10.1590/S0004-2803.24612025-064

Gabriel Amorim Soares Pereira, Maria Luiza Barbosa Ferreira DA Silva, Amanda Albuquerque Farias DA Silva, Fernanda Almeida da Silva de Sá Oliveira, Danilo Costa Marques da Silva Vasconcellos, Fernanda Sales Melo Mendes, Liana Codes, Paulo Lisboa Bittencourt

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Abstract

Background: Gastrointestinal bleeding (GIB) is one of the leading causes of hospitalization attributed to digestive disorders. Little is known about etiology and outcomes of GIB and temporal trends in the incidence of upper GIB (UGIB) and lower GIB (LGIB) in Brazil.

Objective: To investigate the main causes and mortality of patients admitted to a tertiary care hospital in Brazil with UGIB and LGIB, as well as to assess trends in epidemiology and outcomes of GIB over time.

Methods: All patients admitted to the Gastrointestinal (GI) Unit of the Portuguese Hospital of Salvador, Bahia, Brazil with the diagnosis of GIB between January 2012 and December 2023 were retrospectively investigated. All patients with GIB were classified as non-variceal (NUGIB), variceal (VUGIB) UGIB and LGIB according to standard criteria and managed according to an institutional protocol. Demographics, type and etiology of GIB and in-hospital mortality were evaluated in two different periods, between 2012-2017 (period 1) and 2018-2023 (period 2).

Results: 2.145 patients (1.214 males, mean age 70+16 years) were admitted, 1.185 in period 1 and 960 in period 2. Most of the patients had hematochezia and melena. NUGIB, VUGIB, LGIB and mid-GIB were observed in 37.5%, 14.4%, 40.3% and 5.6% of the patients, respectively. The remaining 47 subjects were not investigated due to advanced age or comorbidity. The most common etiologies for UGIB and LGIB were, respectively, esophagogastric varices (EV), duodenal (DU) and gastric ulcer (GU), and colonic diverticular disease (CDD), actinic proctocolitis (APC) and hemorrhoids (HE). Changes in the frequency of LGIB (42.1% vs 38.0% in period 2, P<0.0001) and mid-GIB (3.8% vs 7.9% in period 2, P<0.0001) were recorded over time. Age (68.7+15.6 vs 71+15.7 years in period 2, P=0.001) and gender (54,1% vs 59.1% of males in period 2, P=0.01) were also shown to vary as well as a significant decrease in mortality in recent years (14,2% vs 10.1% of deaths in period 2, P=0.005).

Conclusions: EV, DU, GU and CDD, APC and HE were the most frequent causes of UGB and LGIB, respectively. Shifts in demographics, frequency of LGIB and mid-GIB and mortality were demonstrated in recent years.

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过去12年来巴西急性消化道出血流行病学模式的变化

背景：消化道出血（GIB）是消化系统疾病住院治疗的主要原因之一。在巴西，GIB的病因和结局以及上GIB （UGIB）和下GIB （LGIB）发病率的时间趋势知之甚少。目的：调查巴西一家三级医院收治的UGIB和LGIB患者的主要原因和死亡率，并评估GIB随时间的流行病学趋势和结局。方法：回顾性分析2012年1月至2023年12月在巴西巴伊亚州萨尔瓦多葡萄牙医院胃肠道（GI）病房诊断为GIB的所有患者。所有GIB患者根据标准标准分为非静脉曲张（NUGIB）、静脉曲张（VUGIB）、静脉曲张（UGIB）和LGIB，并根据机构方案进行管理。在2012-2017年（第1期）和2018-2023年（第2期）两个不同时期评估GIB的人口统计学、类型和病因以及住院死亡率。结果：共收治患者2.145例，其中男性1.214例，平均年龄70+16岁，一期1.185例，二期960例。多数患者有便血和黑黑。NUGIB、VUGIB、LGIB和mid-GIB分别占37.5%、14.4%、40.3%和5.6%。其余47名受试者因高龄或合并症未接受调查。UGIB和LGIB最常见的病因分别是食管胃静脉曲张（EV）、十二指肠溃疡（DU）和胃溃疡（GU）、结肠憩室病（CDD）、光化性直结肠炎（APC）和痔疮（HE）。结论：EV、DU、GU和CDD、APC和HE分别是UGB和LGIB最常见的原因。近年来，人口统计数据、LGIB和中期gib的频率以及死亡率发生了变化。

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来源期刊

Arquivos de Gastroenterologia Medicine-Gastroenterology

CiteScore

2.00

自引率

0.00%

发文量

109

审稿时长

9 weeks

期刊介绍： The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.