Greek results of the "ENERGIB" European study on non-variceal upper gastrointestinal bleeding.
BACKGROUND
Non-variceal upper gastro-intestinal bleeding (NVUGIB) is a common and challenging emergency situation. We aimed to describe the characteristics and clinical outcomes of patients with NVUGIB in Greece.


METHODS
ENERGIB (NCT00797641) was an epidemiological survey conducted in 7 European countries including Greece. It included adult patients with overt NVUGIB from 10 tertiary hospitals across Greece. Data for each patient were collected on admission and up to 30 days thereafter.


RESULTS
201 patients were enrolled. A previous history of NVUGIB was reported by 14% of patients, while 61% had ≥ 1 co-morbidities. At presentation, 59% were on therapy that could harm the gastrointestinal mucosa, 14% on anticoagulant(s) and 42% had sign(s) of hemodynamic instability. 54% of patients showed stigmata of recent hemorrhage. Therapeutic endoscopy was performed in 25% and blood product(s) transfusions were required in 86% of cases. Proton pump inhibitors were administered before and after endoscopy in 70% and 95% of patients, respectively. Uncontrolled bleeding or rebleeding was observed in 11% being more common in elderly, hospitalized patients and patients with ≥1 co-morbidities. Second-look endoscopy was performed in 20%, angiographic intervention in 1.5% and surgical intervention in 4% of patients. Only 5/201 (2.5%) patients died during hospitalization and none died during the 30-day post-hospitalization period.


CONCLUSIONS
The majority of patients with NVUGIB in tertiary Greek hospitals are elderly, with co-morbidities, hemodynamic instability and required transfusion(s), while one fourth undergoes therapeutic endoscopic interventions. However, NVUGIB is associated with moderate degrees of continued bleeding/re-bleeding, low surgical rates and, most importantly, low mortality.
2 Department of Internal Medicine, Hippokration Hospital of Athens (George Papatheodoridis).
George
G
Papatheodoridis
4 Department of Internal Medicine, Hippokration Hospital of Thessaloniki (Evangelos Akriviadis).
Evangelos
E
Akriviadis
2 Propedeutic Department of Internal Medicine, Hippokration Hospital of Thessaloniki (Nikolaos Evgenidis).
Nikolaos
N
Evgenidis
Department of Gastroenterology, University Hospital of Larissa (Anargyros Kapetanakis).
Anargyros
A
Kapetanakis
2 Department of Gastroenterology, Evangelismos Hospital of Athens (Demetrios Karamanolis).
Demetrios
D
Karamanolis
2 Department of Internal Medicine, Hippokration Hospital of Thessaloniki (Jannis Kountouras).
Jannis
J
Kountouras
1 Department of Gastroenterology, Evangelismos Hospital of Athens (Gerasimos Mantzaris).
Gerassimos
G
Mantzaris
Academic Department of Gastroenterology, University Hospital of Larissa (Spyros Potamianos).
Spyros
S
Potamianos
Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Athens (Konstantinos Triantafyllou).
Konstantinos
K
Triantafyllou
Department of Gastroenterology, Tzaneio Hospital of Piraeus (Charalambos Tzathas), Greece.
Charalambos
C
Tzathas
co-morbidities; endoscopy; gastrointestinal bleeding; mortality; surgery