An etiological and prognostic evaluation of patients with upper gastrointestinal bleeding from Karadeniz Technical University Department of Emergency Medicine

Abstract

Objective: Upper gastrointestinal (GI) bleeding is a common cause of presentations to the emergency department (ED) which requires urgent diagnosis and treatment with varying mortality rate according to its etiology. A limited number of study from emergency departments in Turkey interested in gastrointestinal bleeding. In the present study, we aimed to determine the etiologies, therapeutic approaches, prognostic factors, rebleedinig rates and short and long term mortality rates of upper GI bleeding who admitted to the ED of Karadeniz Technical University.
Methods: This prospective study, conducted between March 1, 2004 and March 1, 2005, investigated patients with GI bleeding applying to the KTU Medical Faculty Hospital Emergency Department. Etiological causes, therapeutic approaches and prognostic factors together with mortality rates and levels of recurrence of bleeding in or out of hospital was investigated.
Results: Our study included 179 patients with upper GI bleeding. Etiological causes of bleeding were found as erosive gastritis (22.9%), gastric ulcer (22.3%), duodenal ulcer (22.3%), esophageal varices (17.9%) and malignity (%9.5), respectively. Mortality rates were determined as 12.8% in 6 month follow up and as 9.5% in hospital. A total recurrence rate of bleeding rate of 27.9% was also found. The presence of esophageal varices, chronic liver disease, recurrence of bleeding and malignity were associated with increased mortality (p<0.05). Treatment procedures performed were found as medical treatment alone (60.3%), medical and endoscopic (31.3%), medical, endoscopic and surgical treatment (6.1%), medical and surgical treatment (2.2%).
Conclusions: There was no significant difference between the mortality level in our hospital, a reference hospital for GI bleeding patients in the Turkish province of Trabzon, and the data in the literature. Our recurrence of bleeding rate was higher than that in literature, and this was particularly ascribed to the high frequency number of patients with varices and malignity in our hospital.