Acute nonvariceal upper gastrointestinal bleeding—experience of a tertiary care center in southern India

Simon, Ebby George; Chacko, Ashok; Dutta, Amit Kumar; Joseph, Anjilivelil Joseph; George, Biju

doi:10.1007/s12664-013-0305-6

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…[7][8][9][10][11] In addition, in a recent study from South India, peptic ulcer was found to be the most common etiology. [12] Another recent study from Middle East has shown that peptic ulcer disease is the most common cause of UGIB. [13] This shows that the trend is similar with regard to the etiology of UGIB.…”

Section: Discussionmentioning

confidence: 99%

“…Odisha [9] New Delhi [14] Mumbai [15] Chennai [10] Kerala [11] Ahmedabad [16] Shimla [17] Year of study [20] Prospective, Nepal 2010-2013, 589 7.5 6.1 1.2 Simon et al [12] Prospective 2012, 214 8.9 5.1 3.7 Ragesh et al [13] Prospective, Qatar 2012, 251 8.3 10.3 4.7 van Leerdam [8] Prospective, Netherlands 2000, 769 16 13 7 Sato et al [22] Retrospective, Japan 2003-2010, 9987 NA 16.8 NA Del Piano et al [25] Retrospective, Italy In our study, with respect to age and gender, there was no significant difference between the patients with variceal and nonvariceal bleed. In the clinical presentation, hematemesis was significantly more seen in patients with variceal bleed, whereas melena and presence of abdominal pain were significantly more in patients with nonvariceal bleed (P < 0.05).…”

Section: Present Study Kolkatamentioning

confidence: 99%

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Spectrum of upper gastrointestinal bleed: An experience from Eastern India

Parvez

Goenka

Tiwari

et al. 2016

Journal of Digestive Endoscopy

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Background/Aims: The etiology of upper gastrointestinal bleed (UGIB) is variable in different geographical regions. Epidemiological data are helpful in knowing the burden of the problem. This study was conducted to know the etiological spectrum, mortality, morbidity, and predictors of outcome in patients with acute UGIB. Materials and Methods: We retrospectively analyzed the data of patients admitted to our hospital between January 2013 and May 2015, with UGIB and noted the clinical presentation, etiology of bleed, and outcome. Results: A total of 337 patients [272 (80.7%) male, 65 (19.3%) female (male:female ratio: 4:1)] of UGIB were included in the study. The mean age of the patients was 55.11 ± 14.8 years (Range - 14–85 years). The most common etiology of UGIB was peptic ulcer (40.05%) followed by varices (33%). Majority of patients were managed medically. Endotherapy was required only in 33% patients. The mean duration of hospital stay was 6.6 ± 5.79 days. Rebleed was seen in 11 (3.2) patients and surgery was required in 6 (1.7%). In hospital, mortality was 2.6%. Age ≥65 years (odds ratio [OR]: 9.5, 95% confidence interval [CI]: 3.108–29.266), serum albumin <3 g/dl (OR: 3.1, 95% CI: 1.049–9.682), and serum creatinine >2 mg/dl (OR: 4.1, 95% CI: 1.068–8.591) were associated with increased mortality. Conclusions: Peptic ulcer disease is still the most common cause of UGIB. Majority of patients can be managed medically. Rebleed rate, need for surgery, and mortality due to UGIB are declining. Elderly age (>65), hypoalbuminemia serum albumin<3g/dl (<3) and renal dysfunction (serum creatinine >2) are important factors associated with increased mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Present Study Kolkatamentioning

confidence: 99%

Spectrum of upper gastrointestinal bleed: An experience from Eastern India

Parvez

Goenka

Tiwari

et al. 2016

Journal of Digestive Endoscopy

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“…This is consonance with some reports from North India but in other reports peptic ulcer disease remains the commonest cause. 4,5,12 Interestingly, some patients with variceal bleeding had small varices (grade I) which could be due to use of drugs like terlipressin and reduction of size after gastrointestinal bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…1 In studies done in Western population, as well as Southern and coastal India, peptic ulcer disease still constitutes the most common cause of upper gastrointestinal bleed. [2][3][4][5] Upper gastrointestinal endoscopy plays an important role in the diagnosis of etiology of bleed, stratification of patients according to the risk of rebleed based on the endoscopic stigmata and in treatment of such patients.…”

Section: Introductionmentioning

confidence: 99%

Utility of clinical and complete Rockall score in Indian patients with upper gastrointestinal bleeding

Sharma¹

2016

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Introduction: Acute upper gastrointestinal bleeding (AUGIB) is an important gastroenterological emergency. Role of Rockall score in stratification of risk of mortality and rebleeding in Indian patients is uncertain. Methods: This study was prospectively conducted on 175 consecutive patients admitted with AUGIB who were 18 years or above. The clinical Rockall score and complete scores calculated at admission and after endoscopy were analyzed for association with the outcome (rebleeding and mortality) for both variceal and non-variceal bleeding. Results: The mean age of the patients was 48.4±16.4 years and 78.9% were males. History of inake of NSAIDs in patients of AUGIB was present in 13.7% and of antiplatelets in 13.7%. Variceal bleed was the most common etiology (45.7%) followed by peptic ulcer disease (24.0%). Overall rates of surgery, rebleed and mortality were 6.9%, 22.9% and 20% respectively. Both clinical and complete Rockall risk scoring systems were useful tools for stratifying patients with AUGIB into high and low risk categories for mortality. However, for the prediction of rebleed, the complete Rockall scoring system was found to be better than the clinical scoring system. These scoring systems performed much better in predicting the outcomes in non-variceal bleed than in patients with variceal bleed. Multivariate analysis showed that patients with age ≥65 years and albumin <3 g/dl were at an increased risk of mortality. Conclusion: Rockall scoring can be used to stratify patients with AUGIB and is more useful in non-variceal bleeding.

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“…2 Past history of treatment for PUD was in 9.6%, which was similar to as reported by Simon EG et al (12.1%). 10 The assessment of hemodynamic status of the subjects showed 57.7% were hemodynamically stable and 42.3% were unstable which included 24.7% with supine hypotension, in common with study by Simon EG et.al which had 22.4% subjects presenting with shock and 21.7% in study by Dewan KR et al 10,11 The mean hemoglobin (Hb) was 8.224±2.78 g%, similar to study by Chasawat J et al which had 8.5±2.6 g%. The mean Hb was 7.0±2.1 g% in study by Chaikitamnuaychok R.…”

Section: Discussionmentioning

confidence: 99%

Profile of acute upper gastro intestinal bleed: a referral hospital-based study in sub Himalayan region

2018

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Background: Acute upper gastrointestinal bleeding (UGIB) is one of the most common medical emergencies and remains a major cause of morbidity and mortality. We are likely to see more of it in coming years with ageing population, patients with liver disease, increasing use of NSAIDs, single or multiple antithrombotic agents and novel anticoagulants, the present study was designed with the aim to assess the clinical profile of UGIB presenting to the Department of Medicine in sub Himalayan region.Methods: Study done over 12 months included all patients presenting with acute hematemesis and/or melena. Detailed history, clinical examination, blood tests and Upper GI Endoscopy was done in all patients.Results: One hundred seventy-five patients were included in the study, 129 (73.7%) were males. The commonest age group was 41-60 years contributing to 44%, male to female ratio 2.8:1. The commonest presentation was melena, patients with hematemesis presented earlier, with mean duration 1.46 days. 42.3% of patients were hemodynamically unstable at admission. The mean hemoglobin (Hb) was 8.224±2.78 g%. The cause of bleed was shared by ulcer, varices, non-ulcer non-variceal approximately 1/3rd each, major cause being ulcer in 39.4%. Varices was common in age 30-40 yrs, ulcer in age 51 to 70 years.Conclusions: UGI bleed was more frequent in males age between 41-60 yrs, peptic ulcer being the leading cause in our study, presence of signs of liver failure were associated with varices.

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Acute nonvariceal upper gastrointestinal bleeding—experience of a tertiary care center in southern India

Abstract: Peptic ulcer was the most common cause of NVUGIB. Outcomes (rebleed, surgery, and mortality) at our center appear similar to those currently being reported from the West.

Cited by 8 publications

References 38 publications

Spectrum of upper gastrointestinal bleed: An experience from Eastern India

Spectrum of upper gastrointestinal bleed: An experience from Eastern India

Utility of clinical and complete Rockall score in Indian patients with upper gastrointestinal bleeding

Profile of acute upper gastro intestinal bleed: a referral hospital-based study in sub Himalayan region

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