scholarly journals COMPARISON OF NON-ENDOSCOPIC SCORES FOR THE PREDICTION OF OUTCOMES IN PATIENTS OF UPPER GASTROINTESTINAL BLEED IN AN EMERGENCY OF A TERTIARY CARE REFERRAL HOSPITAL: A PROSPECTIVE COHORT STUDY

2021 ◽  
Vol 58 (4) ◽  
pp. 534-540
Author(s):  
Anurag SACHAN ◽  
Deba Prasad DHIBAR ◽  
Ashish BHALLA ◽  
Ajay PRAKASH ◽  
Sunil TANEJA ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Peptic Ulcer Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Early Warning Score ◽  
Ulcer Disease ◽  
Gastrointestinal Bleed ◽  
Rockall Score ◽  
Upper Gastrointestinal

ABSTRACT BACKGROUND: Traditionally peptic ulcer disease was the most common cause of upper gastrointestinal (UGI) bleed but with the changing epidemiology; other etiologies of UGI bleed are emerging. Many scores have been described for predicting outcomes and the need for intervention in UGI bleed but prospective comparison among them is scarce. OBJECTIVE: This study was planned to determine the etiological pattern of UGI bleed and to compare Glasgow Blatchford score, Pre-Endoscopy Rockall score, AIMS65, and Modified Early Warning Score (MEWS) as predictors of outcome. METHODS: In this prospective cohort study 268 patients of UGI bleed were enrolled and followed up for 8 weeks. Glasgow Blatchford score, Endoscopy Rockall score, AIMS65, and MEWS were calculated for each patient, and the area under the receiver operating characteristic (AUC-ROC) curve for each score was compared. RESULTS: The most common etiology for UGI bleed were gastroesophageal varices 150 (63.55%) followed by peptic ulcer disease 29 (12.28%) and mucosal erosive disease 27 (11.44%). Total 38 (15.26%) patients had re-bleed and 71 (28.5%) patients died. Overall, 126 (47%) patients required blood component transfusion, 25 (9.3%) patients required mechanical ventilation and 2 (0.74%) patients required surgical intervention. Glasgow Blatchford score was the best in predicting the need for transfusion (cut off - 10, AUC-ROC= 0.678). Whereas AIMS65 with a score of ≥2 was best in predicting re-bleed (AUC-ROC=0.626) and mortality (AUC-ROC=0.725). CONCLUSION: Gastrointestinal bleed was most commonly of variceal origin at our tertiary referral center in Northern India. AIMS65 was the best & simplest score with a score of ≥2 for predicting re-bleed and mortality.

Impulsivity as a predictor of newly-diagnosed peptic ulcer disease: A prospective cohort study

2006 ◽  
Vol 41 (8) ◽  
pp. 1539-1550 ◽  
Author(s):  
Niklas Granö ◽  
Sampsa Puttonen ◽  
Marko Elovainio ◽  
Marianna Virtanen ◽  
Ari Väänänen ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Peptic Ulcer Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Newly Diagnosed ◽  
Ulcer Disease

scholarly journals Hormonal and reproductive factors and risk of upper gastrointestinal cancers in men: A prospective cohort study within the UK Biobank

2018 ◽  
Vol 143 (4) ◽  
pp. 831-841
Author(s):  
Úna C. Mc Menamin ◽  
Andrew T. Kunzmann ◽  
Michael B. Cook ◽  
Brian T. Johnston ◽  
Liam J. Murray ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Reproductive Factors ◽  
Uk Biobank ◽  
Gastrointestinal Cancers ◽  
The Uk ◽  
Upper Gastrointestinal

scholarly journals Short-term outcomes after emergency surgery for complicated peptic ulcer disease from the UK National Emergency Laparotomy Audit: a cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023721 ◽  
Author(s):  
Benjamin E Byrne ◽  
Michael Bassett ◽  
Chris A Rogers ◽  
Iain D Anderson ◽  
Ian Beckingham ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Peptic Ulcer Disease ◽  
Fatal Outcome ◽  
Mortality Rates ◽  
Emergency Laparotomy ◽  
Ulcer Disease ◽  
Factors Associated ◽  
Institutional Volume ◽  
National Emergency

ObjectivesThis study used national audit data to describe current management and outcomes of patients undergoing surgery for complications of peptic ulcer disease (PUD), including perforation and bleeding. It was also planned to explore factors associated with fatal outcome after surgery for perforated ulcers. These analyses were designed to provide a thorough understanding of current practice and identify potentially modifiable factors associated with outcome as targets for future quality improvement.DesignNational cohort study using National Emergency Laparotomy Audit (NELA) data.SettingEnglish and Welsh hospitals within the National Health Service.ParticipantsAdult patients admitted as an emergency with perforated or bleeding PUD between December 2013 and November 2015.InterventionsLaparotomy for bleeding or perforated peptic ulcer.Primary and secondary outcome measuresThe primary outcome was 60-day in-hospital mortality. Secondary outcomes included length of postoperative stay, readmission and reoperation rate.Results2444 and 382 procedures were performed for perforated and bleeding ulcers, respectively. In-hospital 60-day mortality rates were 287/2444 (11.7%, 95% CI 10.5% to 13.1%) for perforations, and 68/382 (17.8%, 95% CI 14.1% to 22.0%) for bleeding. Median (IQR) 2-year institutional volume was 12 (7–17) and 2 (1–3) for perforation and bleeding, respectively. In the exploratory analysis, age, American Society of Anesthesiology score and preoperative systolic blood pressure were associated with mortality, with no association with time from admission to operation, surgeon grade or operative approach.ConclusionsPatients undergoing surgery for complicated PUD face a high 60-day mortality risk. Exploratory analyses suggested fatal outcome was primarily associated with patient rather than provider care factors. Therefore, it may be challenging to reduce mortality rates further. NELA data provide important benchmarking for patient consent and has highlighted low institutional volume and high mortality rates after surgery for bleeding peptic ulcers as a target for future research and improvement.

Not so Goody’s powder

2021 ◽  
Vol 14 (7) ◽  
pp. e242055
Author(s):  
Raja Samir Khan ◽  
Sardar Momin Shah-Khan ◽  
Justin Kupec
Keyword(s):  
Peptic Ulcer ◽  
Adverse Effects ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Gastrocolic Fistula ◽  
Over The Counter ◽  
Ulcer Disease ◽  
Upper Gastrointestinal ◽  
Acute Anaemia

Over-the-counter analgesic medications are widely used amongst American adults and are also available in powder forms. Their adverse effects have been well documented in literature. Gastrocolic fistulas as a complication of peptic ulcer disease from analgesic powder usage have been previously unreported. Here, we report a patient with upper gastrointestinal bleeding and acute anaemia secondary to peptic ulcer complicated by gastrocolic fistula in a patient using analgesic powder.

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