Incidence and factors associated with high risk upper gastrointestinal bleeding in King Narai Hospital

Abstract

The aim of this study was to evaluate the incidence and factors associated with high risk upper gastrointestinal bleeding(UGIB) in King Narai Hospital. This was a retrospective study including patients with UGIB performed esophagogastroduodenoscopy (EGD) within 72 hours from October 2017 to September 2020. The information was collected in 5 factors (personal factor, contributing factor, clinical factor, endoscopic therapy and outcome) and analyzed by descriptive statistics. The logistric regression analysis was used to examine the association of independent variables.

             Results: A total 320 patients with UGIB were included. The high risk UGIB patients were 72 patients (22.5%). Male gender was 40 patients (55.56%). The incidence of high risk UGIB were gastric ulcer (66.67%), Duodenal ulcer (33.33%). The majority of ulcers were Forrest I (38.9%) and Forrest IIa (33.33%). The endoscopic hemostasis for ulcer bleeding were diluted adrenaline injection with heater probe (72.20%) and diluted adrenaline injection alone (16.70%). Only one patient had recurrent gastrointestinal bleeding required surgical treatment. The multivariate logistic regression analysis of associated risk factors of high risk UGIB were alcohol drinking, NSAIDS used, BUN ≥ 25mg/dl, pulse rate ≥ 100 bpm, hematemesis, hematemesis with melena, hematemesis with hematochezia, Glasgow-Blatchford score(GBS) ≥ 5 and hypotension required IV fluid resuscitation over 2 L