Clinical Characteristics of Acute Upper Gastrointestinal Bleeding in a Tertiary Referral Center.
- Author:
Chang Nyol PAIK
1
;
In Seok LEE
;
Jung Hwan OH
;
Jae Myung PARK
;
Yu Kyung CHO
;
Sang Woo KIM
;
Myung Gyu CHOI
;
In Sik CHUNG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. isle@catholic.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Upper gastrointestinal bleeding;
Prognostic factor
- MeSH:
Acute Disease;
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Blood Transfusion;
Data Interpretation, Statistical;
Demography;
Esophageal and Gastric Varices/*diagnosis/therapy;
Female;
Gastrointestinal Hemorrhage/*diagnosis/mortality/therapy;
Humans;
Male;
Mallory-Weiss Syndrome/*diagnosis/therapy;
Middle Aged;
Peptic Ulcer/*diagnosis/therapy;
Prognosis;
Referral and Consultation;
Retrospective Studies;
Treatment Outcome
- From:The Korean Journal of Gastroenterology
2007;50(1):26-35
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Acute upper gastrointestinal bleeding (UGIB) is still responsible for significant morbidity in spite of various therapeutic advances. The aims of this study were to evaluate the success rate in managing UGIB and predicting factors that affected clinical courses. METHODS: From August 2003 to April 2005, medical data (registered in a standard database categories) of 318 patients who underwent endoscopic examination to evaluate UGIB were analyzed. Early and final treatment success rates were evaluated on the next day and 14 days after the initial endoscopic procedures respectively (or the day of discharge). RESULTS: Main causes of UGIB were peptic ulcer (50.9%), varices (28.3%), Mallory-Weiss syndrome (10.3%). Endoscopic treatments were tried in 200 patients (63.0%). Number of patients who underwent operation and deaths were 4 (1.3%) and 13 (4.1%), respectively. Early and final success rates were 86.2% and 94.0%. Independent prognostic factors related with early success rates were volume of transfusion (OR 0.80, 95% CI 0.72-0.89, p<0.001) and bleeding during the ventilator care (OR 0.03, 95% CI 0.01-0.31, p<0.001), whereas those factors related with final success rates were volume of transfusion (OR 0.79, 95% CI 0.69-0.90, p<0.001), bleeding during the stay in intensive care unit (ICU) (OR 0.12, 95% CI 0.13-0.49, p<0.001). CONCLUSIONS: Early and final success rates of bleeding control were 86.2% and 94.0% in acute UGIB. Volume of transfusion, bleeding during ICU state or ventilator state were important predictive factors of the treatment failure.
