Risk factors associated with NSAID-induced upper gastrointestinal bleeding resulting in hospital admissions: A cross-sectional, retrospective, case series analysis in valencia, spain

Abstract Background Upper gastrointestinal bleeding (UGIB) is a common medical emergency with significant mortality. Despite developments in endoscopic and clinical management, only minor improvements in outcomes have been reported. Methods This was a retrospective cohort study of patients with non-malignant UGIB emergency admissions in England between 2003 and 2015, using Hospital Episode Statistics. Multilevel logistic regression analysis examined the associations with mortality. Results 242 796 patients with an UGIB admission were identified (58.8 % men; median age 70 [interquartile range (IQR) 53 – 81]). Between 2003 and 2015, falls occurred in both 30-day mortality (7.5 % to 7.0 %; P < 0.001) and age-standardized mortality (odds ratio (OR) 0.74, 95 % confidence interval [CI] 0.69 – 0.80; P < 0.001), including from variceal bleeding (OR 0.63, 95 %CI 0.45 – 0.87; P < 0.005). Increasing co-morbidity (Charlson score > 5, OR 2.94, 95 %CI 2.85 – 3.04; P < 0.001), older age (> 83 years, OR 6.50, 95 %CI 6.09 – 6.94; P < 0.001), variceal bleeding (OR 2.03, 95 %CI 1.89 – 2.18; P < 0.001), and a weekend admission (Sunday, OR 1.18, 95 %CI 1.12 – 1.23; P < 0.001) were associated with 30-day mortality. Of deaths at 30 days, 8.9 % were from ischemic heart disease (IHD) and the cardiovascular age-standardized mortality rate following UGIB was high (IHD deaths within 1 year, 1188.4 [95 %CI 1036.8 – 1353.8] per 100 000 men in 2003). Conclusions Between 2003 and 2015, 30-day mortality among emergency admissions with non-malignant UGIB fell by 0.5 % to 7.0 %. Mortality was higher among UGIB admissions at the weekend, with important implications for service provision. Patients with UGIB had a much greater risk of subsequently dying from cardiovascular disease and addressing this risk is a key management step in UGIB.

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The use of the cap and underwater technique as an aid in endoscopic diagnosis and treatment of upper gastrointestinal bleeding: case series

VideoGIE ◽

10.1016/j.vgie.2021.07.005 ◽

2021 ◽

Author(s):

Fernando Lander Mota ◽

Deborah Marques Centeno ◽

Fernando J.S. de Oliveira ◽

Eduardo M.A. Pereira ◽

Sarah Madeira Jacinto ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Case Series ◽

Endoscopic Diagnosis ◽

Diagnosis And Treatment ◽

Upper Gastrointestinal

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OC.06.6 RISK FACTORS FOR MORTALITY FROM NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING IN PATIENTS ALREADY HOSPITALIZED FOR ANOTHER CONDITION

Digestive and Liver Disease ◽

10.1016/s1590-8658(13)60192-9 ◽

2013 ◽

Vol 45 ◽

pp. S70

Author(s):

R. Marmo ◽

M. Koch ◽

L. Cipolletta ◽

E. Grossi ◽

M.A. Bianco ◽

...

Keyword(s):

Risk Factors ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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Factors Associated With Failure of Initial Endoscopic Hemoclip Hemostasis for Upper Gastrointestinal Bleeding

Journal of Clinical Gastroenterology ◽

10.1097/01.mcg.0000190754.25750.c0 ◽

2006 ◽

Vol 40 (1) ◽

pp. 25-28 ◽

Cited By ~ 18

Author(s):

Yen-Chun Peng ◽

Show-Yun Chen ◽

Chun-Fang Tung ◽

Wai-Keung Chou ◽

Wei-Hsiung Hu ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Factors Associated ◽

Upper Gastrointestinal

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Clinical profile of patients presenting to emergency with upper gastrointestinal bleeding in a tertiary hospital of Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v8i2.28839 ◽

2021 ◽

Vol 8 (2) ◽

pp. 105-111

Author(s):

Sunil Adhikari ◽

Suraj Rijal ◽

Darlene Rose House

Keyword(s):

Emergency Department ◽

Gastrointestinal Bleeding ◽

Variceal Bleeding ◽

Clinical Presentation ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Hospital ◽

Clinical Profile ◽

Ulcer Bleeding ◽

Cross Sectional ◽

Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.

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Prevalence and Risk of Polypharmacy among Community-Dwelling, Elderly Kuwaiti Patients

Medical Principles and Practice ◽

10.1159/000503298 ◽

2019 ◽

Vol 29 (2) ◽

pp. 166-173 ◽

Cited By ~ 1

Author(s):

Nabil Ahmed Badawy ◽

Shokria Adely Labeeb ◽

Mawaheb Falah Alsamdan ◽

Badria Faleh Alazemi

Keyword(s):

Risk Factors ◽

Hospital Admissions ◽

Antihypertensive Drugs ◽

Female Gender ◽

Community Dwelling ◽

Older Individuals ◽

Cross Sectional ◽

Factors Associated ◽

High Prevalence ◽

Study Population

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.

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