title: Nonvariceal upper gastrointestinal tract bleeding - risk factors and the value of emergency endoscopy.
abstract: BACKGROUND
  Upper gastrointestinal tract bleeding (UGIB) remains a valid issue of modern medicine. The mortality and recurrence rates remain high and have not decreased as expected over the past decades.
  
  
  OBJECTIVE
  to assess the treatment outcomes of nonvariceal UGIB depending on the timing of endoscopy (urgent vs. elective) and to perform an analysis of risk factors for death in patients with nonvariceal UGIB.
  
  
  METHODS
  Comparative evaluation of treatment outcomes in two groups of patients. Group A consisted of patients undergoing elective endoscopy (n = 187). Group B consisted of patients undergoing emergency endoscopy (n = 295). Moreover, the influence of selected factors on the risk of death and bleeding recurrence was analyzed in the combined population of the two groups. This was done by constructing a logistic regression model and testing dependence hypotheses.
  
  
  RESULTS
  In group A the mortality rate was 9.1%, and the recurrence rate was 18.2%. In group B the values were 6.8% and 12.2%, respectively. No statistically significant difference was found (p = NS). In group B the number of surgical interventions, blood transfusions and intensive care admissions was significantly lower (p < 0.05). An analysis of the combined material showed that the factors which correlated with an elevated risk of death included: old age, hemodynamic state (shock), elevated Charlson Comorbidity Index score, hemoglobin concentration, bleeding from a malignant lesion, recurrent bleeding and the need for surgery (p < 0.05).
  
  
  CONCLUSIONS
  The use of emergency endoscopy improves the treatment outcomes in patients with UGIB, although no statistically significant decrease in the mortality and recurrence rates could be observed.
authors.affiliation: Department of General and Endocrine Surgery, University Hospital No. 1, Bydgoszcz, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Wierzchowski
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Dabrowiecki
authors.forename: Wojciech
authors.initials: W
authors.lastname: Szczesny
authors.forename: Jakub
authors.initials: J
authors.lastname: Szmytkowski
keywords: emergency endoscopy; intestinal tract bleeding; risk factors