Abstract

BACKGROUND
Upper gastrointestinal bleeding (UGIB) remains one of the most common clinical life-threatening emergencies which is associated with a high morbidity, mortality and medical care costs.
OBJECTIVES
This study reviews the clinical features, management and outcomes of patients with UGIB seen at the University Hospital of the West Indies (UHWI), Jamaica, between January 2006 and December 2008.
METHODS
Patients with UGIB admitted to the medical wards of the UHWI, Jamaica, between January 2006 and December 2008 were reviewed. Consecutive patients admitted with a confirmed diagnosis of UGIB were selected for analysis. Data collected included age, gender presenting complaints, risk factors, clinical features and management. Endoscopic findings, treatment and outcomes were also reviewed.
RESULTS
There were 104 patients, with a mean age of 55 years, admitted with UGIB. There were significantly more men than women (73 vs 31). Retching and vomiting were the most common presenting complaints followed by melaena and haemetemesis. Non-steroidal anti-inflammatory drug use was present in 28% of patients. Overall, 80% of patients had upper GI endoscopy (EGD) and 40% were done within 24 hours of admission. The median time for performing EGD was 24 hours (mean 46 hours). The leading causes of UGIB were duodenal ulcer (28%), erosive gastritis (20%) and gastric ulcer (13%). Proton pump inhibitors (PPI) were given to 95 (91%) patients intravenously. Blood transfusion was given to 40% of patients. The mortality was 5.7%, rebleeding occured in 4.8% of patients and 5% underwent surgery. The average duration of hospital stay was 6.6 days.
CONCLUSION
Upper gastrointestinal bleeding was more common in men of middle age in this study. Proton pump inhibitors were used in most patients. The overall mortality of 5.7% is similar to other series. Early EGD and use of endoscopic therapy may lead to a decrease in mortality in high risk patients.

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Authors

Kaliamurthy M, Lee MG, Mills M, Murphy T

Institution

Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.

Source

The West Indian medical journal 60:3 2011 Jun pg 289-92

MeSH

Accessory Atrioventricular Bundle
Anti-Inflammatory Agents, Non-Steroidal
Endoscopy, Gastrointestinal
Female
Gastrointestinal Hemorrhage
Humans
Length of Stay
Male
Middle Aged
Proton Pump Inhibitors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22224340