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KMID : 0614620070500010026
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Korean Journal of Gastroenterology
2007 Volume.50 No. 1 p.26 ~ p.35
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Clinical Characteristics of Acute Upper Gastrointestinal Bleeding in a Tertiary Referral Center
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Paik Chang-Nyol
Choi Myung-Gyu
Chung In-Sik
Kim Sang-Woo
Oh Jung-Hwan
Lee In-Seok
Park Jae-Myung
Cho Yu-Kyung
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Abstract
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Background/Aims: Acute upper gastrointestinal bleeding (UGIB) is still responsible for significant morbidity in spite of various therapeutic advances. The aims of this study were to evaluate the success rate in managing UGIB and predicting factors that affected clinical courses.
Methods: From August 2003 to April 2005, medical data (registered in a standard database categories) of 318 patients who underwent endoscopic examination to evaluate UGIB were analyzed. Early and final treatment success rates were evaluated on the next day and 14 days after the initial endoscopic procedures respectively (or the day of discharge).
Results: Main causes of UGIB were peptic ulcer (50.9%), varices (28.3%), Mallory-Weiss syndrome (10.3%). Endoscopic treatments were tried in 200 patients (63.0%). Number of patients who underwent operation and deaths were 4 (1.3%) and 13 (4.1%), respectively. Early and final success rates were 86.2% and 94.0%. Independent prognostic factors related with early success rates were volume of transfusion (OR 0.80, 95% CI 0.72-0.89, p＜0.001) and bleeding during the ventilator care (OR 0.03, 95% CI 0.01-0.31, p＜0.001), whereas those factors related with final success rates were volume of transfusion (OR 0.79, 95% CI 0.69-0.90, p＜0.001), bleeding during the stay in intensive care unit (ICU) (OR 0.12, 95% CI 0.13-0.49, p＜0.001).
Conclusions: Early and final success rates of bleeding control were 86.2% and 94.0% in acute UGIB. Volume of transfusion, bleeding during ICU state or ventilator state were important predictive factors of the treatment failure.
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KEYWORD
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Upper gastrointestinal bleeding, Prognostic factor
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