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. 2020 Jun 30;58(226):409-415.
doi: 10.31729/jnma.4967.

Clinical Profile and Endoscopic Findings in Patients with Upper Gastrointestinal Bleed Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Subash Bhattarai  1
Affiliations

Clinical Profile and Endoscopic Findings in Patients with Upper Gastrointestinal Bleed Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Subash Bhattarai. JNMA J Nepal Med Assoc. .

Abstract

Introduction: Upper gastrointestinal bleeding is a common acute medical emergency. Endoscopy is the gold standard diagnostic and therapeutic tool in the management of upper gastrointestinal bleed. This study was undertaken to address the clinical profile, endoscopic profile, and outcomes in patients with upper gastrointestinal bleed.

Methods: A descriptive cross-sectional study was conducted in a tertiary care teaching hospital in Gandaki Province, Nepal from January 2018 to December 2019 after obtaining ethical clearance from Institutional Review Committee (MEMG/IRC/291/GA) and informed consent from the patient or patient relatives. The sample size was calculated. Six hundred and sixty patients with upper gastrointestinal bleed were included in the study. Data entry was done in Statistical Packages for the Social Sciences version 20.

Results: Peptic ulcers and ruptured oesophageal varices are the common aetiologies of upper gastrointestinal bleed. Inpatient mortality was seen in 98 (14.8 %) patients. Upper gastrointestinal bleed of variceal etiology presents with a higher Rockall score and has more chances of rebleeding and has higher mortality than those with non-variceal aetiologies. Bad prognostic factors were rebleeding, variceal etiology, and comorbidities including cirrhotic and Rockall score > 6.

Conclusions: Upper gastrointestinal bleeding is a common acute medical emergency. Early upper gastrointestinal endoscopy preferably within 24 hours is recommended for diagnosis, timely intervention, and management of the patients with an upper gastrointestinal bleed that helps in reducing morbidity and mortality.

Keywords: endoscopy; esophageal and gastric varices; peptic ulcer; upper gastrointestinal tract..

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