Spectrum of upper gastrointestinal bleed: An experience from Eastern India

Abstract

Abstract Background/Aims: The etiology of upper gastrointestinal bleed (UGIB) is variable in different geographical regions. Epidemiological data are helpful in knowing the burden of the problem. This study was conducted to know the etiological spectrum, mortality, morbidity, and predictors of outcome in patients with acute UGIB. Materials and Methods: We retrospectively analyzed the data of patients admitted to our hospital between January 2013 and May 2015, with UGIB and noted the clinical presentation, etiology of bleed, and outcome. Results: A total of 337 patients [272 (80.7%) male, 65 (19.3%) female (male:female ratio: 4:1)] of UGIB were included in the study. The mean age of the patients was 55.11 ± 14.8 years (Range - 14–85 years). The most common etiology of UGIB was peptic ulcer (40.05%) followed by varices (33%). Majority of patients were managed medically. Endotherapy was required only in 33% patients. The mean duration of hospital stay was 6.6 ± 5.79 days. Rebleed was seen in 11 (3.2) patients and surgery was required in 6 (1.7%). In hospital, mortality was 2.6%. Age ≥65 years (odds ratio [OR]: 9.5, 95% confidence interval [CI]: 3.108–29.266), serum albumin <3 g/dl (OR: 3.1, 95% CI: 1.049–9.682), and serum creatinine >2 mg/dl (OR: 4.1, 95% CI: 1.068–8.591) were associated with increased mortality. Conclusions: Peptic ulcer disease is still the most common cause of UGIB. Majority of patients can be managed medically. Rebleed rate, need for surgery, and mortality due to UGIB are declining. Elderly age (>65), hypoalbuminemia serum albumin<3g/dl (<3) and renal dysfunction (serum creatinine >2) are important factors associated with increased mortality.