[Clinical characteristics of acute upper gastrointestinal bleeding in a tertiary referral center].
OBJECTIVE
Acute upper gastrointestinal bleeding (UGIB) is still responsible for significant morbidity in spite of various therapeutic advances. The aims of this study were to evaluate the success rate in managing UGIB and predicting factors that affected clinical courses.


METHODS
From August 2003 to April 2005, medical data (registered in a standard database categories) of 318 patients who underwent endoscopic examination to evaluate UGIB were analyzed. Early and final treatment success rates were evaluated on the next day and 14 days after the initial endoscopic procedures respectively (or the day of discharge).


RESULTS
Main causes of UGIB were peptic ulcer (50.9%), varices (28.3%), Mallory-Weiss syndrome (10.3%). Endoscopic treatments were tried in 200 patients (63.0%). Number of patients who underwent operation and deaths were 4 (1.3%) and 13 (4.1%), respectively. Early and final success rates were 86.2% and 94.0%. Independent prognostic factors related with early success rates were volume of transfusion (OR 0.80, 95% CI 0.72-0.89, p<0.001) and bleeding during the ventilator care (OR 0.03, 95% CI 0.01-0.31, p<0.001), whereas those factors related with final success rates were volume of transfusion (OR 0.79, 95% CI 0.69-0.90, p<0.001), bleeding during the stay in intensive care unit (ICU) (OR 0.12, 95% CI 0.13-0.49, p<0.001).


CONCLUSIONS
Early and final success rates of bleeding control were 86.2% and 94.0% in acute UGIB. Volume of transfusion, bleeding during ICU state or ventilator state were important predictive factors of the treatment failure.
Paik
Chang Nyol
CN
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lee
In Seok
IS
Oh
Jung Hwan
JH
Park
Jae Myung
JM
Cho
Yu Kyung
YK
Kim
Sang Woo
SW
Choi
Myung-Gyu
MG
Chung
In-Sik
IS
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D003627:Data Interpretation, Statistical; D003710:Demography; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000628:therapy; D011379:Prognosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome