Etiology, risk factors, and endoscopic profile in patients presenting with upper gastrointestinal bleeding – An observational study

Abstract

Objectives: Upper gastrointestinal bleeding (UGIB) poses a strong diagnostic and therapeutic challenge to emergency physicians and gastroenterologists. There are wide variations in the etiological profile of UGIB, and it often varies with the demography of the patient clientele. A thorough understanding of these changing patterns of the etiological profile, characteristics of the affected patients, and treatment outcomes in the wake of constantly evolving diagnostic and therapeutic protocols are vital for healthcare providers. The aim is to study the clinical profile and assess possible risk factors and endoscopic findings among the patients presenting with UGIB at two different centers: Armed Forces Tertiary Care Teaching Hospital and Civil Tertiary Care Hospital. Materials and Methods: This is a cross-sectional observational study conducted at two centers: A tertiary care hospital of the armed forces (n = 113) from September 2015 to January 2018 and a civil tertiary care center in a tier 3 city (n = 178) from January 2019 to November 2021. The study population comprised patients presenting with UGIB. All patients diagnosed with UGIB and confirmed by endoscopy were enrolled in the study. Results: The study included patients presenting with UGIB visiting either of the two tertiary care centers. The majority of the study population (75%) was male. Between the two clinical settings, alcohol consumption was higher in proportion in the army tertiary care than those visiting the civil tertiary care. Relatively, a history of UGIB (35%), acid peptic disease (23%), and cirrhosis of the liver (35%) was high among the armed forces tertiary care patients. Among the patients visiting a tier 3 civil hospital, more than two-thirds were diagnosed with gastritis (66.67%) and carcinoma of the esophagus (17%). Conclusion: The etiology of UGIB varies with different clinical care settings. The risk factors are majorly driven by sociocultural factors, respectively.