Published online Mar 26, 2024. doi: 10.12998/wjcc.v12.i9.1597
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
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.
This research was designed to collect clinical data from patients experiencing ANVUGIB at our hospital. The objective was to identify clinical features unique to our institution and to evaluate the efficacy of endoscopic hemostasis treatment.
The aim is to clarify the distinct clinical characteristics associated with our institution and to assess the therapeutic efficacy of endoscopic hemostasis.
We conducted a retrospective analysis of 532 patients diagnosed with ANVUGIB via endoscopy at our hospital from March 2021 to March 2023, utilizing our electronic medical records system. Data encompassing general patient demographics, etiological factors, clinical outcomes, and other pertinent variables were scrupulously gathered and examined.
In the cohort of 532 patients diagnosed with ANVUGIB, the male-to-female ratio was 2.91:1, indicating a higher incidence in males. Notably, 43.6% of these patients reported black stool as their primary symptom, while 27.4% initially presented with hematemesis. On admission, 17% of patients showed symptoms of both hematemesis and black stool. The majority of ANVUGIB patients primarily complained of overt gastrointestinal bleeding. Urgent hematological assessments upon admission revealed that 75.8% of the patients were anemic, with 63.4% suffering from moderate to severe anemia, and 1.5% exhibiting extremely severe anemia (Hemoglobin < 30 g/L). Etiologically, 53.2% experienced bleeding without an identifiable trigger, 24.2% had a history of ingesting gastric mucosa-irritating medications, 24.2% developed bleeding post alcohol consumption, 2.8% linked their bleeding to improper diet, 1.7% to emotional excitement, and 2.3% to fatigue prior to the bleeding episode. Drug-induced ANVUGIB was more common in the elderly compared to middle-aged and younger individuals, while alcohol-related bleeding was more frequent in younger patients. Moreover, diet-related bleeding incidents were predominantly observed in the younger demographic compared to middle-aged individuals. Gastrointestinal endoscopy revealed peptic ulcers as the leading cause of ANVUGIB, accounting for 73.3% of cases, followed by gastrointestinal malignancies (10.9%), acute gastric mucosal lesions (9.8%), and androgenic upper gastrointestinal bleeding (1.5%). Of the 532 patients with gastrointestinal bleeding, 68 underwent endoscopic hemostasis, representing a treatment rate of 12.8%, with a notably high immediate hemostasis success rate of 94.1%.
Patients across various age groups present with distinct characteristics, and endoscopic hemostatic treatments showed significant efficacy.
This retrospective analysis focused on patients diagnosed with ANVUGIB via endoscopic examination at our hospital. The study underscored the unique characteristics of ANVUGIB patients across various age demographics. Additionally, it determined the therapeutic effectiveness of endoscopic hemostatic treatment, affirming its efficiency in managing ANVUGIB, improving treatment outcomes, and advocating for its wider implementation.