Predictive Factors of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding

Abstract

Background: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is one of the most common medical emergencies and often represents a life-threatening event. The aim of this study is to find potential predictive factors associated with 30-day mortality in patients with NVUGIB. Methods and Results: Our prospective study was conducted in Mother Teresa Hospital between May 2022 and December 2022. A total of 224 patients (aged >18 years) with NVUGIB were included in the study. Demographical and clinical characteristics, endoscopic findings, and laboratory tests were reviewed during a 30-day follow-up period. Logistic regression was employed to identify the independent predictors of mortality. The mean age of the 224 patients enrolled in the study was 63.21±16.3 years and most patients (72.8%) were male. One hundred fifty (66.9%) patients had comorbidities. The most common endoscopic diagnoses underlying NVUGIB episodes were duodenal ulcers (53.1%). Recurrent bleeding was recorded in 50(22.3%) patients. Out of 224 patients included in the study, 24(10.7%) died within 30 days of admission, 20(8.9%) died during hospitalization, and 4(1.8%) died after discharge. The mean age of death was 76.42±12.59 years; 95.8% of deaths were associated with one or more major comorbidities. In the multivariate logistic regression, after the exclusion of confounding factors, low red blood cell (RBC) (P=0.043, OR=0.413, CI 95%: 0.176-0.974), warfarin (P=0.036, OR=10.547, CI 95%: 1.165-95.462), and Rockall score (RS) >5 (P=0.034, OR=4.107, CI 95%: 1.114-15.139) were found to be independent predictive factors for mortality. Conclusion: The 30-day mortality rate remained high after NVUGIB, especially during hospitalization. Low RBC, warfarin, and RS>5 were independent factors of mortality in patients with NVUGIB.