On the effect of therapeutic endoscopy on mortality rate in patients with upper gastrointestinal bleeding

گوارش، مجله انجمن متخصصين گوارش و كبد ايران

دوره 20 - شماره Supple.1

Article Type: Original Article
Abstract: Introduction: Gastrointestinal bleeding (GIB) is a widespread clinical problem, resulting in a significant mortality, particularly in patients older than 60 years. Although about %80 of GIB cases are likely to be terminated without any clinical intervention, the remaining %20 result in serious diagnostic and medication difficulties. The spread of hospitalization due to upper gastrointestinal bleeding (UGIB) and the mortality rate corresponding to it are reported to be around %0.1 and less than %5, respectively. Methods: In this paper, among the cases diagnosed with UGIB during 1999-2005, the cases with at least one of the indications of therapeutic endoscopy have been studied, using appropriate case group (including 210 patients, i.e. %63.6) and control group (including 120 patients, i.e. %36.4). Results:Major findings of the study are as the following. Mortality rate is around %20 in the case group and %12.5 in the control group. The medical treatment for about %13.3 of patients in the case group and %32.5 of patients in the control group resulted in surgery. On average, patients in the case and control groups are hospitalized for 5.52±4.22 and 7.00±6.61 days, respectively. Average units of transfusions is found to be 6.76±6.58 within the case group and 9.68±8.38 within the control group. Conclusion: Our investigations show no significant difference between case and control groups in aspects of age, sex and co-morbidities (including cardiopulmonary diseases, diabetes, hyperlipidemia, smoking and addiction). However, the study indicates a significant reduction in the need for surgery, required transfusions and duration of hospitalization for the patients who have experienced therapeutic endoscopy, compared to the ones who have not received such a remedy. In contrast to some previous studies, no meaningful correlation is observed between the mortality rate and execution of therapeutic endoscopy in UGIB cases.