Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series

Upper gastrointestinal bleeding and factors affecting the rebleeding risk

“…A multivariate analysis was also performed using variables that were significant in the univariate analysis. The results show that tachycardia and high creatinine levels were independent risk factors of rebleeding in UGIB, whilst albumin was an independent protective factor from rebleeding [1]. Similarly, in a retrospective study by Laz r, Ursoniu, and Goldiş which consists of one thousand five hundred and eighty one NVUGIB patients, presence of hemodynamic instability or shock (systolic blood pressure <100 mmHg and/or pulse rate >100 beats per minute) at admission were significantly related to rebleeding.…”

“…There is still no certain definition of rebleeding itself. Jiménez-Rosales et al defined rebleeding as the presence of fresh hematemesis and/or melena associated with the development of shock or a reduction in the hemoglobin concentration of more than 2 g/dl over 24 hours [1], but other studies have mentioned different definitions of rebleeding. In a previous retrospective study by Laz r, Ursoniu, and Goldiş, rebleeding was defined as the recurrence of active digestive hemorrhage (hematemesis, melena or hematochezia), hemodynamic instability, or a decrease in the hemoglobin level of more than 2 g/dL within 24 h of the first endoscopic procedure associated with the endoscopic visualization of active bleeding at the site of the previously treated lesion [3].…”

“…In the recent times, majority of UGIB patients are older and present with multiple comorbidities [3]. Rebleeding occurs in 10-20% of UGIB cases [1], but multiple studies have reported higher incidence rates of rebleeding. A retrospective analysis by Nam et al showed that rebleeding occurred in 41 (20.7%) out of 198 patients [6].…”

“…This suggests that PRC transfusion might be more useful to predict rebleeding as transfusion is a surrogate marker for low hemoglobin levels, usually below 7g/dL to 9 g/dL [13]. Other prognostic laboratory markers include high creatinine levels and low albumin levels which indicates a recent bleeding or presence of a severe comorbidity [1]. Endoscopic results such as active bleeding at endoscopy or need for therapy has also been associated with rebleeding in UGIB by several studies [1,3,13].…”

“…Upper gastrointestinal bleeding (UGIB) remains as one of the most common causes of hospitalisations [1], with an estimated incidence rate of 80 to 150 cases per 100,000 people annually worldwide [2]. Despite therapeutic advances in the treatment of UGIB including endsocopic hemostasis modalities and use of proton pump inhibitors (PPI) [3], incidence of rebleeding remains relatively high at 7-16% and increases mortality in UGIB patients [4].…”