Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran
<b>Background/Aim:</b> The prevalence of acute upper gastrointestinal bleeding (AUGIB) has undergone a change after implementation of eradication therapy for <i>Helicobacter pylori</i> in peptic ulcers effective prevention of esophageal variceal bleeding and eventually, progr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2010-01-01
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| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2010;volume=16;issue=4;spage=253;epage=259;aulast=Kaviani |
| _version_ | 1819266053132255232 |
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| author | Kaviani Mohammad Pirastehfar Mohsen Azari Ali Saberifiroozi Mehdi |
| author_facet | Kaviani Mohammad Pirastehfar Mohsen Azari Ali Saberifiroozi Mehdi |
| author_sort | Kaviani Mohammad |
| collection | DOAJ |
| description | <b>Background/Aim:</b> The prevalence of acute upper gastrointestinal bleeding (AUGIB) has undergone a change after implementation of eradication therapy for <i>Helicobacter pylori</i> in peptic ulcers effective prevention of esophageal variceal bleeding and eventually, progressive use of low dose aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs). To evaluate this subject, we performed a prospective study in two main University Hospitals of Shiraz (the largest city of southern Iran). <b>Materials and Methods:</b> All adults who were admitted in emergency room with impression of AUGIB and existing patients who developed AUGIB were included in the study. Gastroscopy was done with a follow-up for the next 15 days. <b>Results:</b> 572 patients (mean age: 54.9 years) entered in the study. The most common presenting symptom was hematemesis or coffee-ground vomits (68%). 75% of patients gave history of consumption of low dose aspirin or other NSAIDs regularly. Gastric and/or duodenal ulcers were the most common causes (252/572, 44%) of AUGIB (Gastric ulcer: 173/572, 30% and duodenal ulcer: 93/572, 16%, respectively). Esophageal varices were the third common cause (64/572, 11%). 36 (6%) of the patients died. Mean age of these patients was higher than the patients who were alive (64.8 vs. 54.2 years, <i>P</i> = 0.001). Other than age, orthostatic hypotension on arrival (267/536 vs. 24/36, <i>P</i> = 0.018) and consumption of steroids (43/536 vs. 10/36, <i>P</i> = 0.001) were significant factors for increasing mortality. <b>Conclusion:</b> The most common cause of AUGIB, secondary only to NSAIDs consumption, is gastric ulcer. Mortality of older patients, patients who consumed NSAIDs and steroids concomitantly, and patients with hemodynamic instability on arrival were higher. |
| first_indexed | 2024-12-23T20:55:09Z |
| format | Article |
| id | doaj.art-b9129a299e3a465b8881d996a67d02e8 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-12-23T20:55:09Z |
| publishDate | 2010-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-b9129a299e3a465b8881d996a67d02e82022-12-21T17:31:33ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492010-01-01164253259Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of IranKaviani MohammadPirastehfar MohsenAzari AliSaberifiroozi Mehdi<b>Background/Aim:</b> The prevalence of acute upper gastrointestinal bleeding (AUGIB) has undergone a change after implementation of eradication therapy for <i>Helicobacter pylori</i> in peptic ulcers effective prevention of esophageal variceal bleeding and eventually, progressive use of low dose aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs). To evaluate this subject, we performed a prospective study in two main University Hospitals of Shiraz (the largest city of southern Iran). <b>Materials and Methods:</b> All adults who were admitted in emergency room with impression of AUGIB and existing patients who developed AUGIB were included in the study. Gastroscopy was done with a follow-up for the next 15 days. <b>Results:</b> 572 patients (mean age: 54.9 years) entered in the study. The most common presenting symptom was hematemesis or coffee-ground vomits (68%). 75% of patients gave history of consumption of low dose aspirin or other NSAIDs regularly. Gastric and/or duodenal ulcers were the most common causes (252/572, 44%) of AUGIB (Gastric ulcer: 173/572, 30% and duodenal ulcer: 93/572, 16%, respectively). Esophageal varices were the third common cause (64/572, 11%). 36 (6%) of the patients died. Mean age of these patients was higher than the patients who were alive (64.8 vs. 54.2 years, <i>P</i> = 0.001). Other than age, orthostatic hypotension on arrival (267/536 vs. 24/36, <i>P</i> = 0.018) and consumption of steroids (43/536 vs. 10/36, <i>P</i> = 0.001) were significant factors for increasing mortality. <b>Conclusion:</b> The most common cause of AUGIB, secondary only to NSAIDs consumption, is gastric ulcer. Mortality of older patients, patients who consumed NSAIDs and steroids concomitantly, and patients with hemodynamic instability on arrival were higher.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2010;volume=16;issue=4;spage=253;epage=259;aulast=KavianiAcute upper gastrointestinal bleedinggastric ulcernonsteroidal antiinflammatory drugs |
| spellingShingle | Kaviani Mohammad Pirastehfar Mohsen Azari Ali Saberifiroozi Mehdi Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran The Saudi Journal of Gastroenterology Acute upper gastrointestinal bleeding gastric ulcer nonsteroidal antiinflammatory drugs |
| title | Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran |
| title_full | Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran |
| title_fullStr | Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran |
| title_full_unstemmed | Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran |
| title_short | Etiology and outcome of patients with upper gastrointestinal bleeding: A study from South of Iran |
| title_sort | etiology and outcome of patients with upper gastrointestinal bleeding a study from south of iran |
| topic | Acute upper gastrointestinal bleeding gastric ulcer nonsteroidal antiinflammatory drugs |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2010;volume=16;issue=4;spage=253;epage=259;aulast=Kaviani |
| work_keys_str_mv | AT kavianimohammad etiologyandoutcomeofpatientswithuppergastrointestinalbleedingastudyfromsouthofiran AT pirastehfarmohsen etiologyandoutcomeofpatientswithuppergastrointestinalbleedingastudyfromsouthofiran AT azariali etiologyandoutcomeofpatientswithuppergastrointestinalbleedingastudyfromsouthofiran AT saberifiroozimehdi etiologyandoutcomeofpatientswithuppergastrointestinalbleedingastudyfromsouthofiran |