Characteristics of Patients with Nonvariceal Upper Gastrointestinal Bleeding - Are We Underestimating Gastroprotection during NSAIDs Therapy?

Authors

  • Nerma Čustović Clinic for gastroenterohepatology, Clinical University Center Sarajevo
  • Aida Saray Clinic for gastroenterohepatology, Clinical University Center Sarajevo
  • Samra Ćato-Mehmedbašić Clinic for gastroenterohepatology, Clinical University Center Sarajevo
  • Ira Tančica Clinic for gastroenterohepatology, Clinical University Center Sarajevo
  • Sanjin Sprečkić Clinic for gastroenterohepatology, Clinical University Center Sarajevo
  • Nedim Tokić Clinic for urgent medicine, Cinical University Center Sarajevo
  • Naida Herenda Clinic for anesthesiology and reanimation, Clinical University Center Sarajevo

DOI:

https://doi.org/10.5644/ama2006-124.340

Keywords:

Mortality, Transfusion, Forrest Classification

Abstract

Objective. The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract.

Materials and Methods. This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up.

Results. The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients.

Conclusion. The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors,with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.

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Published

2021-11-21

How to Cite

Čustović, N., Saray, A., Ćato-Mehmedbašić, S., Tančica, I., Sprečkić, S., Tokić, N., & Herenda, N. (2021). Characteristics of Patients with Nonvariceal Upper Gastrointestinal Bleeding - Are We Underestimating Gastroprotection during NSAIDs Therapy?. Acta Medica Academica, 50(2), 244–251. https://doi.org/10.5644/ama2006-124.340

Issue

Section

Clinical Medicine

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