Original Article

Upper Gastrointestinal Bleeding: One Center's Five Years Experience

10.5505/1304.8503.2012.19870

  • Esma GÜLDAL ALTUNOĞLU
  • Cüneyt MÜDERRİSOĞLU
  • Füsun ERDENEN
  • Hasan BEKTAŞ
  • Hayri POLAT

Received Date: 28.05.2012 Accepted Date: 22.06.2012 İstanbul Med J 2012;13(4):169-175

Objectives:

Upper gastrointestinal bleeding (UGIB) is important for hospitalization. We investigated the etiologies and risk factors of 792 patients admitted to our hospital over five years.

Methods:

792 patients admitted with hematemesis and/or melena were included in the study. Histories, examinations, laboratory tests, and endoscopic procedures were reported. Lesions that caused bleeding were determined, and they were identified based on Forrest classification. The specimens were evaluated in the pathology laboratory. The control group consisted of 713 patients without bleeding who had undergone gastroscopy for other complaints.

Results:

There were 550 male and 242 female subjects. The percentage of GI bleeding was 70% among patients ≥40 years. Helicobacter pylori positivity with CLO tests was observed in 163 patients. The most frequent lesions were duodenal ulcer, mucosal lesions, hiatal hernia, esophageal varices, stomach ulcer, stomach cancer, and portal hypertensive gastropathy. There was history of non-steroidal antiinflammatory drug (NSAID) use in 29.5%. The middle-aged group (54.2±15.8) presented with a higher frequency of bleeding due to NSAID. Duodenal ulcer and mucosal lesions were observed more commonly among smokers and middle-aged male patients. 44 patients had a history of alcohol, which correlated with mucosal lesions, esophageal varices and portal hypertensive gastropathy. 290 patients had a history of recurrent GI bleeding, which was associated with mucosal lesions, peptic ulcer and esophageal varices.

Conclusion:

UGIB is still important for morbidity and mortality. The common use of endoscopy and the increase in experience enable treatments. However, age, comorbidities, and anti-thrombolytic and NSAID use continue to increase risks.

Keywords: Duodenal ulcer, risk factors, upper gastrointestinal bleeding