Upper Gastrointestinal Bleeding: A Retrospective, Single-Center Experience on the Role of Endoscopy and Outcomes

Authors

  • Ali Someili Department of Medicine, Faculty of Medicine, Jazan University, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Sarah Jaber Mobarki Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Razan Hamoud Moafa Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Leena Nageeb Alsury Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Roaa Hassan Shadad Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Shroog Mohammed Fathi Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Amnah Hussain Hamrani Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Afnan Mohammed Darisi Faculty of medicine, Jazan University, Jazan, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Amal H. Mohamed Department of Medicine, Faculty of Medicine, Jazan University, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Sameer Alqassimi Department of Medicine, Faculty of Medicine, Jazan University, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia
  • Mostafa Mohrag Department of Medicine, Faculty of Medicine, Jazan University, Saudi Arabia Address: Jazan University, Jazan, Postal code: 45142, Saudi Arabia https://orcid.org/0009-0008-9353-6520
  • Mohammed Abdulrasak Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden Department of Gastroenterology and Nutrition, Skåne University Hospital, Malmö, Sweden Address: Jan Waldenströms gatan 35, Malmö, Sweden.

DOI:

https://doi.org/10.14740/jocmr6134

Keywords:

Ulcer, Proton pump inhibitors, Rebleeding, Mortality, Saudi Arabia, Epidemiology

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common and potentially fatal medical emergency. This study aimed to investigate the frequency, causes, outcomes, and efficacy of endoscopy in the treatment of UGIB at King Fahad Central Hospital in Jazan, Saudi Arabia.

Methods: Between January 2017 and December 2023, a retrospective study was performed including all hospitalized patients with UGIB. This research investigated sociodemographic characteristics, clinical history, endoscopic findings, treatment options, and results using statistical analysis, which included both descriptive and inferential approaches.

Results: The study included 483 patients (of which 74.1% men), with a mean age of 53.9 ± 19.5 years. Hematemesis was observed in 67.5% of the patients, whereas melena occurred in 49.7% of the cases. Two-hundred sixty-two (54.2%) patients underwent endoscopy within the first 24 h from presentation. The most frequent endoscopic findings were esophageal varices (52.2%) and duodenal ulcers (21.7%). Bandings accounted for 48.0% of all endoscopic procedures, whereas 36.9% of the patients received epinephrine injections along with endoclips. Medical therapy mostly consisted of a mix of proton pump inhibitors (PPIs) and octreotide. A significant minority (43.5%) of the patients stayed in the hospital for 1 - 3 days, while 59.6% did not need blood transfusions. During the first 3 days, 7% of patients experienced rebleeding, with a 6% mortality rate. Using multivariate regression analysis, rebleeding was strongly associated with initial presentation with shock (P < 0.001), renal disease (P = 0.01), and increased transfusion requirement (P = 0.001). Mortality was strongly associated with steroid usage (P = 0.007), increasing transfusion requirements (P < 0.0001), and rebleeding (P = 0.002).

Conclusions: Timely endoscopy and proper treatment dramatically improved UGIB results. Identifying those who are at high risk and acting swiftly is a critical step in reducing the likelihood of recurrent bleeding and fatality.

Downloads

Published

2025-01-14

Issue

Vol. 17, No. 1, Jan 2025

Section

Original Article

License

Copyright (c) 2025 Journal of Clinical Medicine Research

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

How to Cite

1.
Someili A, Mobarki SJ, Moafa RH, et al. Upper Gastrointestinal Bleeding: A Retrospective, Single-Center Experience on the Role of Endoscopy and Outcomes. J Clin Med Res. 2025;17(1):22-34. doi:10.14740/jocmr6134