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. 2021 Sep 16;9(10):E1504-E1511.
doi: 10.1055/a-1508-5871. eCollection 2021 Oct.

Prognostic factors associated with upper gastrointestinal bleeding based on the French multicenter SANGHRIA trial

Vincent Quentin  1 , André-Jean Remy  2 , Gilles Macaigne  3 , Rachida Leblanc-Boubchir  4 , Jean-Pierre Arpurt  5 , Marc Prieto  6 , Carelle Koudougou  7 , Laurent Tsakiris  8 , Denis Grasset  9 , René-Louis Vitte  10 , David Cuen  11 , Juliette Verlynde  12 , Khaldoun Elriz  13 , Marie-Pierre Ripault  14 , Florent Ehrhard  15 , Mathieu Baconnier  16 , Sofia Herrmann  17 , Nathalie Talbodec  18 , You-Heng Lam  19 , Karine Bideau  20 , Laurent Costes  21 , Florence Skinazi  22 , Ivan Touze  23 , Denis Heresbach  24 , Pierre Lahmek  25 , Stéphane Nahon  26 ; Members of the Association Nationale des Hépato-gastroentérologues des Hôpitaux Généraux (ANGH) SANGHRIA Study Group
Collaborators, Affiliations

Prognostic factors associated with upper gastrointestinal bleeding based on the French multicenter SANGHRIA trial

Vincent Quentin et al. Endosc Int Open. .

Abstract

Background and study aims Prognostic and risk factors for upper gastrointestinal bleeding (UGIB) might have changed overtime because of the increased use of direct oral anticoagulants and improved gastroenterological care. This study was undertaken to assess the outcomes of UGIB in light of these new determinants by establishing a new national, multicenter cohort 10 years after the first. Methods Consecutive outpatients and inpatients with UGIB symptoms consulting at 46 French general hospitals were prospectively included between November 2017 and October 2018. They were followed for at least for 6 weeks to assess 6-week rebleeding and mortality rates and factors associated with each event. Results Among the 2498 enrolled patients (mean age 68.5 [16.3] years, 67.1 % men), 74.5 % were outpatients and 21 % had cirrhosis. Median Charlson score was 2 (IQR 1-4) and Rockall score was 5 (IQR 3-6). Within 24 hours, 83.4 % of the patients underwent endoscopy. The main causes of bleeding were peptic ulcers (44.9 %) and portal hypertension (18.9 %). The early in-hospital rebleeding rate was 10.5 %. The 6-week mortality rate was 12.5 %. Predictors significantly associated with 6-week mortality were initial transfusion (OR 1.54; 95 %CI 1.04-2.28), Charlson score > 4 (OR 1.80; 95 %CI 1.31-2.48), Rockall score > 5 (OR 1.98; 95 %CI 1.39-2.80), being an inpatient (OR 2.45; 95 %CI 1.76-3.41) and rebleeding (OR 2.6; 95 %CI 1.85-3.64). Anticoagulant therapy was not associated with dreaded outcomes. Conclusions The 6-week mortality rate remained high after UGIB, especially for inpatients. Predictors of mortality underlined the weight of comorbidities on outcomes.

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Conflict of interest statement

Competing interests Dr. Nahon has received lecture fees from MSD, Takeda and Sandoz, and consulting fees from MSD, Takeda, Janssen, Sandoz, Ferring, and Vifor. Dr. Arotcarena has received funds from Gilead and Abbvie to attend meetings. Dr. Macaigne has received funding from Jansen, Takeda, Abbvie, and Tillots to attend meetings.

Figures

Fig. 1
Fig. 1
Flowchart of the population.
See this image and copyright information in PMC

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