Peptic Ulcer Is the Most Common Cause of Non-Variceal Upper-Gastrointestinal Bleeding (NVUGIB) in China

Abstract

BackgroundThis study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012.Material/MethodsHospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software.ResultsTotal of 2977 hospitalized patients from 8 medical centers were included. A total of 95.47% (2842/2977) of patients were admitted to a general ward, 3.53% (105/2977) were admitted to an emergency ward, and 1.00% (31/2977) were admitted to an intensive care unit. Peptic ulcer remained the most common cause of NVUGIB (73.26%), but there was a declining trend in its constituent ratio, from 2008 to 2012. A total of 14.41% (429/2977) of patients had co-morbid conditions, 92.85% (2764/2977) used proton-pump inhibitors (PPIs) prior to endoscopic treatment, 19.65% (585/2977) underwent emergency endoscopy, and 23.45% (698/2977) received a transfusion of red blood cell suspensions. A total of 5.34% (159/2977) underwent endoscopic therapy, with a treatment rate of 16.9% in high-risk peptic ulcer patients (96/568). A total of 7.69% (237/2977) were administered aspirin, of whom 32.50% (77/237) resumed aspirin intake after gastrointestinal bleeding was controlled. The median length of hospitalization was 8 days (IQR, 5–11) and the mortality rate was 1.71% (51/2977).ConclusionsPeptic ulcer was still the most common cause of NVUGIB in China. The proportion of patients with high-risk peptic ulcer bleeding who received endoscopic therapy was 16.9%. Only 19.65% of NVUGIB patients underwent emergency endoscopy.

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial

“… 21 , 22 The hospital LOS for patients with NVUGIB varied greatly among institutions, ranging from 3.8 to 8.7 days. 17 , 21 , 23 The mean hospital LOS for NVUGIB patients is 8 days in China, 24 which is higher than that in Korea (LOS: 6 days) 25 and the USA (LOS: 4.5 days). 26 Hay’s study showed that LOS could be lowered by having dedicated personnel to monitor patients with UGIB on a daily basis; however, this intervention is cumbersome and costly.…”

Hypertonic dextrose spray as topical endoscopic hemostasis for non-variceal upper gastrointestinal bleeding

“…Based on previous studies, the mortality rate could be influenced by delays in performing endoscopy (i.e., > 24 hours), the presence of comorbidities, and the presence of lesions that are classified as high risk for peptic ulcer bleeding (Forrest Ia-IIb). 30 Several theories on how hypertonic dextrose acts as a hemostatic agent have been proposed. Hypertonic dextrose causes osmotic dehydration, which then induces mural necrosis of blood vessels, resulting in their obliteration, as well as inflammation and fibrosis in the perivascular space.…”

Effects of Autologous Platelet-Rich Plasma on Healing of Peptic Ulcers: A Randomized Controlled Trial

“…As a result of the weather condition, local residents like to add some seasoning on the food, such as chili peppers and Chinese prickly ash, and spicy food can affect gastrointestinal function and further cause gastrointestinal disease. This may be an important reason that the incidence rate of peptic ulcer is higher in Chongqing than that in other regions and why many patients with peptic ulcer in this region have more severe conditions and are more difficult to treat in the long term [30]. Thus, we strictly required that all patients should not eat spicy food as much as possible during the course of the treatment, and the enrolled patients fully complied with this requirement according to the follow-up results.…”