Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2024; 12(9): 1597-1605
Published online Mar 26, 2024. doi: 10.12998/wjcc.v12.i9.1597
Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis
Xiao-Juan Wang, Yu-Peng Shi, Li Wang, Ya-Ni Li, Li-Juan Xu, Yue Zhang, Shuang Han
Xiao-Juan Wang, Yu-Peng Shi, Li Wang, Ya-Ni Li, Li-Juan Xu, Yue Zhang, Shuang Han, Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Author contributions: Wang XJ and Shi YP reviewed the literature and participated in drafting the manuscript; Wang XJ drafted the manuscript; Wang L, Li YN, Xu LJ and Zhang Y revised the manuscript for important intellectual content; Wang XJ and Han S reviewed and revised the manuscript; Han S contributed to conception and design of the study, manuscript supervision, financial support; All authors read and approved the final version of this manuscript.
Supported by Xi’an Health Commission Residential Training Base Construction Project, No. 2023zp09.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Honghui Hospital, Xi’an Jiaotong University (Approval No. 202205043).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shuang Han, PhD, Professor, Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, No. 555 Youyi East Road, Xi’an 710054, Shaanxi Province, China. shuanghamy@163.com
Received: November 18, 2023
Peer-review started: November 18, 2023
First decision: January 5, 2024
Revised: January 17, 2024
Accepted: February 28, 2024
Article in press: February 28, 2024
Published online: March 26, 2024
Processing time: 128 Days and 7.1 Hours
Abstract
BACKGROUND

Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) constitutes a prevalent emergency within Gastroenterology, encompassing 80%-90% of all gastrointestinal hemorrhage incidents. This condition is distinguished by its abrupt onset, swift progression, and notably elevated mortality rate.

AIM

To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.

METHODS

We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023, utilizing our medical record system. Data pertaining to general patient information, etiological factors, disease outcomes, and other relevant variables were meticulously collected and analyzed.

RESULTS

Among the 532 patients diagnosed with ANVUGIB, the male-to-female ratio was 2.91:1, with a higher prevalence among males. Notably, 43.6% of patients presented with black stool as their primary complaint, while 27.4% had hematemesis as their initial symptom. Upon admission, 17% of patients exhibited both hematemesis and black stool, while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding. Urgent routine blood examinations at admission revealed that 75.8% of patients had anemia, with 63.4% experiencing moderate to severe anemia, and 1.5% having extremely severe anemia (hemoglobin < 30 g/L). With regard to etiology, 53.2% of patients experienced bleeding without a definitive trigger, 24.2% had a history of using gastric mucosa-irritating medications, 24.2% developed bleeding after alcohol consumption, 2.8% attributed it to improper diet, 1.7% to emotional excitement, and 2.3% to fatigue preceding the bleeding episode. Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals, while bleeding due to alcohol consumption showed the opposite trend. Additionally, diet-related bleeding was more common among the young age group compared to the middle-aged group. Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB (73.3%), followed by gastrointestinal malignancies (10.9%), acute gastric mucous lesions (9.8%), and androgenic upper gastrointestinal bleeding (1.5%) among inpatients with ANVUGIB. Of the 532 patients with gastrointestinal bleeding, 68 underwent endoscopic hemostasis, resulting in an endoscopic treatment rate of 12.8%, with a high immediate hemostasis success rate of 94.1%.

CONCLUSION

ANVUGIB patients exhibit diverse characteristics across different age groups, and endoscopic hemostatic treatments have demonstrated remarkable efficacy.

Keywords: Acute non-varicose upper gastrointestinal bleeding; Clinical characteristics; Cause of disease; Endoscopic homeostatic therapy

Core Tip: This retrospective study analyzed the data of patients diagnosed with acute non-varicose upper gastrointestinal bleeding (ANVUGIB) through endoscopic examinations at our hospital. The results revealed distinct characteristics among patients of different age groups with ANVUGIB. Although this study was conducted at a single center, the age and gender distribution of the patients in this study were similar to those reported in previous multicenter studies in China. The study also assessed the therapeutic effectiveness of endoscopic hemostatic treatment, and indicated that it is an effective approach for treating ANVUGIB, improving efficacy, and deserves wider application.