The risk factors for the recurrent upper gastrointestinal hemorrhage among acute peptic ulcer disease patients in Syria: A prospective cohort study

Bitar, Ahmad Naoras; Moussa, Maen

doi:10.1016/j.amsu.2022.103252

Cited by 14 publications

(8 citation statements)

References 28 publications

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“…The number of deaths was 13 (6.5%); which is similar to other studies [1] [4]. Our study showed a statistically signi cant relation between mortality rate and elderly (age greater than 55 years), which is similar to a study done in the United Kingdom where it showed that the most important independent prognostic predictors of mortality at three years were older age; moreover, a similar result was found in a Syrian study [8] [9]. Similar to a Syrian study, our study did not show a statistically signi cant result that the male gender is a prognostic factor, which is explained by the small size of the sample.…”

Section: Discussionsupporting

confidence: 92%

“…More than half of the patients in our study were smokers; however, none of them died. The main symptom at the presentation in our study sample was melena (68.3%), followed by coffee-ground emesis (34.2%), which is similar to another Syrian study where out of 155 patients, 70% of them had melena [9]. However, in this study, the second most common symptom was hematemesis, while coffee-ground emesis happened in only 20% of the patients.…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, 34.2% had active bleeding at the presentation, which is considered a bad prognostic factor [2]. However, none of the previous results showed statistically signi cant results in contrast to another Syrian study which showed a statistically signi cant relationship between the history of blood transfusion and blood unit and the existence of active bleeding with a bad prognosis [9]. As for endoscopic ndings, we found that the most prominent diagnosis was gastric ulcer 138 (69.3%), followed by esophageal varices 50 (25.1%) and tumor 9 (4.5%), respectively.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Upper Gastrointestinal Bleeding and Its Relationship with Death Incidence

Alabedeen

Alzaal

Ali

2022

Preprint

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Background: Upper gastrointestinal bleeding (UGIB) is a life-threatening medical emergency characterized by bleeding from the esophagus, stomach, or duodenum. This study aims to analyze the factors associated with the occurrence of death in patients. Methods: This retrospective study was conducted in the period between 2021–2022, the hospital’s consent was obtained to view patients’ data, samples were collected from patient records in the Gastrointestinal Division of the hospital. The study included 199 patients admitted to the Gastrointestinal Division who were diagnosed with gastrointestinal bleeding at Al-Mujtahid Hospital in Damascus, the exclusion criteria included both archival errors, and cases with incomplete data that cannot be studied. Results: Out of the 199 patients, 68.8% were male and 31.2% were female. The average age of patients was 57.4 years, melena was the most prominent clinical manifestation of bleeding, with 68.2% of patients, followed by Coffee ground vomiting by 34.2%, 30.2% with a history of unexplained hypotension, and 26.1% with a history of haematemesis. The majority used the Rockall warning system with a percentage of 98.5%. The majority had concomitant heart disease 31.2%. Considering the drugs used, aspirin, corticosteroids, and clopidogrel were the top results, 39.9% of patients had a history of heart, 96.5% of patients were conscious, and endoscopy revealed active bleeding in 34.2%. 69.3% had gastric ulcers, 25.1% had esophageal varices, and the majority had a Forrest Ia rating of 32.2% and a grade III of 30.2%. 37.2% needed endoscopic intervention, 19.1% had banding, 11.6% had thermal coagulation, and 10.1% had laparotomy. Death occurred in 6.5% of patients, while 83.4% needed a surgery. Our results found a statistically significant relationship between the incidence of death and each of the advanced age, cardiac antecedents, haematemesis, Coffee ground vomiting, and esophageal varices. Conclusion: Our findings reveal the association of various factors with the incidence of death in cases of UGIB reviewed at Damascus Hospital.These results are significant but may not be generalizable, so we recommend conducting more comprehensive studies.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Upper Gastrointestinal Bleeding and Its Relationship with Death Incidence

Alabedeen

Alzaal

Ali

2022

Preprint

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“…Our patients were younger compared to contemporary studies and majority were in the third to sixth decade of life with a mean age of 40.9±15.9 years. This is in comparison to other studies by Villanueva et al[8], Travis et al[9], Liu et al[10], Daniela et al[11], Laursen et al[12], and Bitar et al[13] where in the mean age of studied subjects was 64.9±15; 64.9±15.3, 55.3±17.8,66,74, 52±16.8 years, respectively. Most of our patient population 361/480 (75%) was from rural areas but gender was equally distributed between the two groups.…”

supporting

confidence: 57%

Predictors of Rebleeding in Non-variceal Upper Gastrointestinal Bleeding of Peptic Ulcer Etiology in Kashmiri Population

Parveen¹,

Shah²,

Zargar³

et al. 2023

Cureus

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BackgroundUpper gastrointestinal bleeding (UGIB) represents a substantial clinical and economic burden and rebleeding is one of the most important predictors of morbidity and mortality. Identifying patients who are likely to rebleed is a critical component of effectively managing patients with bleeding peptic ulcers. So, the study was undertaken to look for predictors of rebleeding in patients with bleeding peptic ulcers and try to find out the new scoring system to predict rebleeding in our population. Material and methodsA retrospective analysis of prospectively maintained hospital data of UGIB patients was done and 480 patients of endoscopically documented peptic ulcers whose complete data was available were taken for study. ResultsAmong the studied patients, men constituted 84.6%, and most of the patients were in the third to sixth decade of life with a mean age of 40.9±15.9 years, 76% were from rural areas. Only males with a mean age of 38.4±19.8 rebled with a rebleeding rate of 2.9% only. Half of the patients who rebled were in shock at the time of presentation. Those who rebled received more units of blood transfusion (mean 3±1.8), had a large mean ulcer size of Forest class IIa and IIb and epinephrine injection monotherapy group with varied statistical significance. Among rebleeders (n=14), eight patients were managed by a second endoscopic therapy, and six (42.8%) rebleeders and 1.25% of patients in total needed surgery. Two patients ultimately died giving overall mortality of 0.4% and mortality of 14.3% among rebleeders. ConclusionOur study found a very low rebleeding rate and mortality which could be explained by a young population with fewer co-morbidities and better response to proton pump inhibitor therapy. The significant parameters related to rebleeding were shock at presentation, degree of smoking, units of blood transfused, ulcer size, and high-risk endoscopic stigmata.

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“…Nonsteroidal anti‐inflammatory drugs (NSAIDS) and disease‐modifying anti‐rheumatic drugs (DMARDS) are the most commonly used drugs to treat rheumatoid arthritis (Thakur et al, 2018; Voshaar et al, 2022). However, these drugs can cause serious side effects such as peptic ulcers, intestinal bleeding and heart attacks (Bitar & Moussa, 2022; Chen et al, 2002; Nagata et al, 2016; Thomas et al, 2017). Doctors and scientists are eagerly awaiting new anti‐RA drugs that are highly effective and less toxic and can improve patient compliance.…”

Section: Introductionmentioning

confidence: 99%

Anti‐rheumatoid arthritis effects of Xanthii Fructus by affecting the PI3K‐AKT signaling pathway based on TMT‐labeled quantitative proteomics

Jiang

Zhang

et al. 2022

Biomedical Chromatography

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Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic symmetrical multiple arthritis. Current traditional counter‐therapies are expensive and have side effects. Xanthii Fructus has effects in expelling wind and cold, draining the nasal orifice, and removing wind and dampness. However, its mechanism of action against rheumatoid arthritis is unknown. In this paper, the mechanism of the anti‐ rheumatoid arthritis effect of Xanthii Fructus is studied by proteomics. The experimental results show that it could significantly reduce serum inflammatory factor levels, alleviate joint edema, improve vasodilation and congestion, and significantly reduce the number of inflammatory cells. Proteomics results show that the PI3K‐AKT signaling pathway is the key pathway for Xanthii Fructus to treat rheumatoid arthritis. In this study, we obtained a new understanding of the mechanism of Xanthii Fructus in the treatment of rheumatoid arthritis, which provided a theoretical basis for its prevention and treatment and laid the foundation for further research.

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The risk factors for the recurrent upper gastrointestinal hemorrhage among acute peptic ulcer disease patients in Syria: A prospective cohort study

Cited by 14 publications

References 28 publications

Evaluation of Upper Gastrointestinal Bleeding and Its Relationship with Death Incidence

Evaluation of Upper Gastrointestinal Bleeding and Its Relationship with Death Incidence

Predictors of Rebleeding in Non-variceal Upper Gastrointestinal Bleeding of Peptic Ulcer Etiology in Kashmiri Population

Anti‐rheumatoid arthritis effects of Xanthii Fructus by affecting the PI3K‐AKT signaling pathway based on TMT‐labeled quantitative proteomics

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