[Variceal and non-variceal upper gastrointestinal bleeding. Analysis of 249 hospitalized patients].

Hemorragia digestiva alta variceal y no variceal: mortalidad intrahospitalaria y características clínicas en un hospital universitario (2015-2017).

Journal

Revista medica de Chile
ISSN: 0717-6163
Titre abrégé: Rev Med Chil
Pays: Chile
ID NLM: 0404312

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 16 10 2019
accepted: 16 03 2020
entrez: 31 7 2020
pubmed: 31 7 2020
medline: 22 9 2020
Statut: ppublish

Résumé

Upper gastrointestinal bleeding (UGIB) is one of the main reasons of hospitalization due to gastrointestinal causes. Reported mortality rates range from 5 to 12%. To determine hospital mortality and associated risk factors in hospitalized patients with UGIB. To compare the clinical characteristics and outcomes of patients with variceal versus non-variceal UGIB. Review of medical records of 249 patients (62% males) discharged with the diagnosis of UGIB at a clinical hospital between 2015 to 2017. Demographic and clinical characteristics and adverse clinical outcomes (surgery, length of hospital stay and in-hospital mortality) were recorded. A comparative analysis between patients with Variceal and Non-variceal UGIB was carried out. Seventy two percent of UGIB were non-variceal (peptic ulcer in 44%). Two patients required surgery (both died). Median of length of hospital stay was seven days (interquartile range (IQR) 4-13). Overall hospital mortality was 13 and 4% in variceal and non-variceal UGIB, respectively (p = 0.024). The variables associated with mortality were: red blood cell transfusion (odds ratio (OR): 18.7, p < 0.01), elevated creatinine on admission (OR: 3.30, p = 0.03) and variceal bleeding (OR: 3.23, p = 0.02). Hospital mortality of UGIB remains high, especially in variceal UGIB. Elevated creatinine levels on admission, the need of transfusion of red blood cells and variceal etiology are risk factors for mortality.

Sections du résumé

BACKGROUND BACKGROUND
Upper gastrointestinal bleeding (UGIB) is one of the main reasons of hospitalization due to gastrointestinal causes. Reported mortality rates range from 5 to 12%.
AIM OBJECTIVE
To determine hospital mortality and associated risk factors in hospitalized patients with UGIB. To compare the clinical characteristics and outcomes of patients with variceal versus non-variceal UGIB.
MATERIAL AND METHODS METHODS
Review of medical records of 249 patients (62% males) discharged with the diagnosis of UGIB at a clinical hospital between 2015 to 2017. Demographic and clinical characteristics and adverse clinical outcomes (surgery, length of hospital stay and in-hospital mortality) were recorded. A comparative analysis between patients with Variceal and Non-variceal UGIB was carried out.
RESULTS RESULTS
Seventy two percent of UGIB were non-variceal (peptic ulcer in 44%). Two patients required surgery (both died). Median of length of hospital stay was seven days (interquartile range (IQR) 4-13). Overall hospital mortality was 13 and 4% in variceal and non-variceal UGIB, respectively (p = 0.024). The variables associated with mortality were: red blood cell transfusion (odds ratio (OR): 18.7, p < 0.01), elevated creatinine on admission (OR: 3.30, p = 0.03) and variceal bleeding (OR: 3.23, p = 0.02).
CONCLUSIONS CONCLUSIONS
Hospital mortality of UGIB remains high, especially in variceal UGIB. Elevated creatinine levels on admission, the need of transfusion of red blood cells and variceal etiology are risk factors for mortality.

Identifiants

pubmed: 32730372
pii: S0034-98872020000300288
doi: 10.4067/S0034-98872020000300288
pii:
doi:

Types de publication

Journal Article

Langues

spa

Sous-ensembles de citation

IM

Pagination

288-294

Auteurs

Carolina Pinto (C)

Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile.

Pía Parra (P)

Escuela de Medicina, Universidad de Chile, Santiago, Chile.

José Magna (J)

Escuela de Medicina, Universidad de Chile, Santiago, Chile.

Abraham Gajardo (A)

Sección de Medicina Interna, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile.

Zoltan Berger (Z)

Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile.

Cristián Montenegro (C)

Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile.

Pablo Muñoz (P)

Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico Universidad de Chile, Santiago, Chile.

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Classifications MeSH