Changes in aetiology and clinical outcome of acute upper gastrointestinal bleeding during the last 15 years

Thomopoulos, K.; Vagenas, Konstantinos; Vagianos, Constantine; Margaritis, Vasileios; Blikas, Alexandros; Katsakoulis, Evangelos; Nikolopoulou, V.

doi:10.1097/00042737-200402000-00009

Cited by 112 publications

(89 citation statements)

References 21 publications

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“…They also only identified deaths that occurred before discharge. The low mortality identified in this study (3.5%) is similar to other North American, 12 and Mediterranean studies, 5,147 but is much lower than other European studies. 3,26,61 However, a study of Medicare patients in the US found that the proportion being managed as outpatients varied between states from 18.6%-45.3%.…”

Section: Other Studiessupporting

confidence: 88%

“…25 Other non variceal haemorrhage studies from Spain(n=17,663), 5 the Netherlands (n=1,720), 3 Greece (n=1,304) 147 , France (n=1,165) 61 and Italy (n=1,126), 26 did not identify reductions in non variceal inpatient mortality. Although these were large studies they may have been underpowered to detect a change, and none of them adjusted the trends in case fatality for changes in co-morbidity.…”

Section: Other Studiesmentioning

confidence: 96%

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Epidemiology of Upper Gastrointestinal Bleeding

Crooks¹,

Sung²,

Card³

2014

GI Epidemiology

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Section: Other Studiessupporting

confidence: 88%

Section: Other Studiesmentioning

confidence: 96%

Epidemiology of Upper Gastrointestinal Bleeding

Crooks¹,

Sung²,

Card³

2014

GI Epidemiology

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“…Additionally, more than a quarter of patients were over 80 years of age. Ten years earlier in our area this percentage was 9.8% [16] . It is clear therefore that now we have to deal with an older population with a higher risk of deterioration due to the presence of higher co-morbidities, making their management a clinical challenge.…”

Section: Discussionmentioning

confidence: 53%

Acute upper gastrointestinal bleeding in octοgenarians: Clinical outcome and factors related to mortality

Theocharis¹,

Arvaniti²,

Assimakopoulos³

et al. 2008

WJG

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AIM:To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS:We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Fo u r h u n d re d a n d s i x t e e n p a t i e n t s over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presence of severe co-morbidity (P < 0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

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“…A study comparing the causes of upper gastrointestinal bleeding among patients admitted to a hospital in Greece between 1986 and 2001 found an increase in the rate of GU (12 vs. 19%; p = 0.005) and a concomitant decrease in the rate of DU (49 vs. 33%; p < 0.0001) [16]. …”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Lau

Sung²,

Hill³

et al. 2011

Digestion

459

334

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Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4–57.0 and 3.8–14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4–19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5–21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≧1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8–11.4) after hemorrhage and 23.5% (95% CI: 15.5–31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.

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Changes in aetiology and clinical outcome of acute upper gastrointestinal bleeding during the last 15 years

Abstract: The aetiology of AUGIB has changed during the last 15 years probably due to the better therapeutic approach to chronic duodenal ulcers and increasing use of NSAIDs in the elderly. Emergency surgical haemostasis has been reduced but the reduction of mortality was not significant.

Cited by 112 publications

References 21 publications

Epidemiology of Upper Gastrointestinal Bleeding

Epidemiology of Upper Gastrointestinal Bleeding

Acute upper gastrointestinal bleeding in octοgenarians: Clinical outcome and factors related to mortality

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

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