The Clinical Features of Upper Gastrointestinal Bleeding after Acute Burn Injury.
- Author:
Geun Sook KIM
1
;
Hyun Joo JANG
;
Chang Soo EUN
;
Sea Hyub KAE
;
Woo Jung PARK
;
Wook CHUN
;
Jong Hyun KIM
;
Jin LEE
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. jinleeprof@hanmail.net
- Publication Type:Original Article
- Keywords:
Burn;
Upper gastrointestinal bleeding
- MeSH:
Burns*;
Duodenal Ulcer;
Esophageal and Gastric Varices;
Gastritis;
Hemorrhage*;
Humans;
Korea;
Logistic Models;
Mallory-Weiss Syndrome;
Medical Records;
Mortality;
Peptic Ulcer;
Proton Pumps;
Retrospective Studies;
Risk Factors;
Stomach Ulcer;
Ulcer
- From:Korean Journal of Gastrointestinal Endoscopy
2005;31(2):77-83
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Upper gastrointestinal (UGI) bleeding is one of the most common and serious complications in major burns. However, the clinical features of UGI bleeding have rarely been studied, and no report of UGI bleeding after burn injury has been presented in Korea. The aim of this study was to evaluate the clinical features of the UGI bleeding after acute burn injury. METHODS: Among 2,340 patieats with acute burn injury who have admitted from January 2000 to June 2004, 33 patients had UGI bleeding. We retrospectively reviewed the medical records of these 33 patients. RESULTS: The causes of bleeding were gastric ulcer (45.5%), duodenal ulcer (36.4%), esophageal ulcer (6%), Mallory-Weiss tear (6%), hemorrhagic gastritis (3%), and gastric varix (3%). Endoscopic intervention and medical treatment were taken in 13 patients (39.4%), and 20 patients (60.6%) were managed with medical treatment only. Mortality rate of post-burn UGI bleeding patients was 30.3%. In logistic regression analysis, burn size (p=0.047) and Rockall score (p=0.019) were independent risk factors of mortality in patients with UGI bleeding. CONCLUSIONS: The most common cause of UGI bleeding in burn patients is peptic ulcer. Treatment of systemic complications of burn as well as UGI bleeding itself may be important in clinical course of UGI bleeding after burn. Large, randomized, and prospective study of prophylactic proton pump inhibitor for the prevention of post-burn UGI bleeding is needed.
