Prospective Observational Study on Clinical and Epidemiological Profile of Adult Patients Presenting to the Emergency Medicine department with Upper Gastrointestinal Bleed

Abstract

Background and objective Bleeding from the upper gastrointestinal tract is one of the common medical emergencies. In this study, we assessed patients' socio-demographic and clinical characteristics and the association of clinical characteristics with treatment outcomes among patients with upper gastrointestinal bleed (UGIB) presenting to the emergency medicine department. At present, there is a scarcity of data on upper GI bleed in Northern part of India. Material and method The study was a single-center, prospective observational study conducted at an urban tertiary care center. Consecutive patients with UGIB were enrolled in the study from August 2020 to February 2022. A detailed history was obtained, including demographic data such as age and sex, presenting complaints, history of presenting illness, history related to co-morbidities, addiction, and drug history. Pre-endoscopic Rockall and Glasgow-Blatchford Score were calculated for each patient. The patients were subsequently followed up till discharge from the hospital. The final outcomes with regard to mortality, need for blood transfusion, length of emergency department (ED), and hospital stay and discharge were noted. Result 141 patients were included in the study. The mean age of the patients with UGIB was 48.62 ± 14.63 years. 115(81.6%) patients were male compared to 26(18.4%) Females. The most common co-morbidity was chronic liver disease (40;28.4%). The most frequent presenting complaint in this study was hematemesis (96; 68.1%), followed by melena (76;53.9%). The mean (SD) of the Rockall Score was 2.46 ± 1.75. The mean (SD) of the Glasgow Blatchford Score was 12.46 ± 3.15 in patients with upper gastrointestinal bleed. Conclusion In our study, hematemesis was the most prevalent symptom of an upper GI bleed, followed by melena. Portal hypertension was the more common cause of upper GI bleed. Alcohol intake, NSAIDs abuse, and co-morbidities such as underlying chronic liver disease, hypertension, and diabetes are independent risk factors in patients with upper GI bleed. Early upper GI endoscopy can lower the morbidity, mortality, and length of hospital stay in patients with upper GI bleed.