Risk Markers for Mortality in Hemodynamically Stable Patients Admitted to the Emergency Department with a Prediagnosis of Upper Gastrointestinal Bleeding

Abstract

Aim: The aim of this study is to investigate the changes in hemoglobin levels in hemodynamically stable patients admitted to the emergency department with a prediagnosis of upper GI bleeding. Material and Methods: This study consisted of patients aged over 18 years who applied to the emergency department of Ankara Training and Research Hospital and underwent endoscopy with a prediagnosis of upper GI bleeding between January 1st, 2017, and March 1st, 2020. The patients’ demographic data, laboratory parameters, Glasgow-Blatchford and Rockall scores, endoscopy results, and 28-day mortality data were recorded. Results: The study sample consisted of 120 patients with a mean age of 62.0 ± 20.9 years. No significant difference was detected in the amount or percentage of change in patients' hemoglobin levels between the two measurements performed at admission and within 3-6 hours. ((0.6(-5,6%), 0.4(-5,3%), p>0.05)) The most common endoscopic finding was a peptic ulcer, which was detected in 64 (53.3%) patients. The multivariate regression analysis revealed that age ((Odds Ratio (OR) = 1.13, confidence interval (CI) 95%: 1.03–1.31, p = 0.0031)) and hypertension (OR = 11.45, CI 95%: 1.80–138.88, p = 0.021) were independent risk factors for 28-day mortality. Conclusion: No significant difference was detected in the amount or percentage of change in hemoglobin levels of hemodynamically stable patients with a prediagnosis of upper GI bleeding between the two measurements performed at admission and within 3-6 hours. Older age and hypertension were determined as the risk factors that predicted 28-day mortality in this patient group.