Re-bleed and Mortality Amongst Patients Following Initial Endoscopy for Upper Gastrointestinal Bleeding: A Single-Center Nigeria Study.
endoscopy
outcome
upper gastrointestinal bleeding
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
27 Jan 2021
27 Jan 2021
Historique:
entrez:
3
3
2021
pubmed:
4
3
2021
medline:
4
3
2021
Statut:
epublish
Résumé
Background and aim Clinical and endoscopic parameters are predictive of patient outcome following acute upper gastrointestinal bleeding. The study aimed to investigate factors related to re-bleed and mortality following initial endoscopy among Nigerian patients with recent upper gastrointestinal bleeding (UGIB). Methods This is a cohort study of patients undergoing endoscopy for recent-onset UGIB at a referral endoscopy facility in Port Harcourt, Rivers State, Nigeria, from April 2014 to November 2020. Patients' demographic and clinical data, American Society of Anesthesiologists (ASA) physical status, amount of blood transfusion, endoscopy results, and Rockall scores were retrieved from patients' charts. The re-bleed and mortality rates were noted on follow-up by telephone. Statistical analysis was performed using SPSS version 20 (IMB Inc., Armonk, USA). Results A total of 560 patients had flexible video oesophagogastroduodenoscopy during the study period, and 46 (8.2%) of these were included in the study. Their age ranged from 28 years to 84 years (mean 58.6 ± 15.8 years) with 32 (69.6%) males and 14 (30.4%) females. Peptic ulcer disease (PUD) and gastritis/gastric erosions were the leading endoscopic diagnoses in 24 (52.2%) and 12 (26.1%) patients, respectively. Multiple comorbidities (p=0.021) and higher ASA score (mean 3.0; 95% confidence interval CI: 2.47-3.53; p=0.021) are associated with re-bleed, which was recorded in seven (15.2%) patients. Four (8.7%) cases of mortality were recorded in patients with a mean full Rockall score of 4.25 (95% CI: 1.52-6.97; p=0.021). Conclusion Re-bleed is more common in patients with multiple comorbidities, ASA score of three or more, and bleeding gastro-oesophageal varices at initial endoscopy. Mortality was significantly higher in patients with a full Rockall score of more than three.
Identifiants
pubmed: 33654618
doi: 10.7759/cureus.12939
pmc: PMC7909892
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e12939Informations de copyright
Copyright © 2021, Ray-Offor et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMC Gastroenterol. 2014 Dec 10;14:210
pubmed: 25492399
Gut. 1996 Mar;38(3):316-21
pubmed: 8675081
Gut. 1999 Mar;44(3):331-5
pubmed: 10026316
Int J Surg Case Rep. 2016;28:42-44
pubmed: 27677116
BMJ. 1995 Jul 22;311(6999):222-6
pubmed: 7627034
Gastroenterol Rep (Oxf). 2020 Apr 01;8(4):299-305
pubmed: 32843977
Eur J Gastroenterol Hepatol. 2002 May;14(5):497-501
pubmed: 11984147
Saudi J Gastroenterol. 2000 May;6(2):87-91
pubmed: 19864718
Med Arch. 2020 Aug;74(4):270-274
pubmed: 33041443
Gut. 1990 May;31(5):504-8
pubmed: 2351300
Niger J Surg. 2015 Jul-Dec;21(2):106-10
pubmed: 26425062
Gastrointest Endosc. 2008 Mar;67(3):422-9
pubmed: 18206878
Saudi J Gastroenterol. 2002 Jan;8(1):17-21
pubmed: 19861786
Am J Gastroenterol. 2012 Aug;107(8):1190-5; quiz 1196
pubmed: 22688850
East Afr Med J. 1989 Feb;66(2):97-9
pubmed: 2788073
BMC Gastroenterol. 2017 Dec 20;17(1):165
pubmed: 29262794
Arch Intern Med. 2007 Jun 25;167(12):1291-6
pubmed: 17592103
Saudi J Gastroenterol. 2012 Jan-Feb;18(1):34-9
pubmed: 22249090
Endoscopy. 1989 Nov;21(6):258-62
pubmed: 2693077
Am J Gastroenterol. 2012 Mar;107(3):345-60; quiz 361
pubmed: 22310222
Lancet. 1996 Apr 27;347(9009):1138-40
pubmed: 8609747
Hepatology. 1992 Dec;16(6):1343-9
pubmed: 1446890
Lancet. 1986 Mar 1;1(8479):462-4
pubmed: 2869207