Acute upper gastrointestinal bleeding in southern Saudi Arabia: A retrospective observational study

Alzahrani MA, Alfaifi M, Alzaher SA, Saad SS, Alshehri FM, Almatrafi MJ, Hammad MS, Nebrawi KY, Alshehri AM, Elmalahy TM, Shehata SF

Pdf Page Numbers :- 105-113

Mohammed Attieh Alzahrani^1,*, Mohammed Alfaifi², Sultan Abdullah Alzaher², Saad Shaker Saad², Fahad Mohammed Alshehri³, Mohammed Jameel Almatrafi³, Mushabab Saeed Hammad³, Khalid Yousef Nebrawi³, Abdullah Mohammed Alshehri³, Tamer Mamdouh Elmalahy³, and Shahata F Shehata^4,5

¹Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia

²Department of Medicine, Assir Central Hospital, Abha, Saudi Arabia

³Gastroenterology Division, Assir Central Hospital, Abha, Saudi Arabia

⁴College of Medicine, King Khalid University, Abha, Saudi Arabia

⁵High Institute of Public Health, Alexandria University, Egypt

*Correspondence author: Mohammed Attieh Alzahrani, Assistant Professor, Department of Internal Medicine, College of Medicine, King Khalid University, P.O Box 641, Abha, Zip code: 61421, Kingdom of Saudi Arabia. Tel: 00966504586134; Email: mohammedalzahrani641@gmail.com; dr_mohdaz@hotmail.com

Received 23 April 2019; Revised 15 June 2020; Accepted 20 June 2020; Published 25 June 2020

Citation: Alzahrani MA, Alfaifi M, Alzaher SA, Saad SS, Alshehri FM, Almatrafi MJ, Hammad MS, Nebrawi KY, Alshehri AM, Elmalahy TM, Shehata SF. Acute upper gastrointestinal bleeding in southern Saudi Arabia: A retrospective observational study. J Med Sci Res. 2020; 8(3):105-113. DOI: http://dx.doi.org/10.17727/JMSR.2020/8-15

Copyright: © 2020 Alzahrani MA et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PDF

Abstract

Context: Upper gastrointestinal bleeding (UGIB) is a common life-threatening emergency that carries considerable mortality and morbidity; it remains a common cause for admission to hospitals worldwide. UGIB is classified as variceal bleeding and non-variceal bleeding because of distinct etiologies and management.

Aims: To describe present clinical manifestations in southern Saudi Arabian UGIB patients, including both endoscopic and basic laboratory parameters, to assess the risk factors, and compare the predictive power and clinical usefulness of three risk scoring systems (AIMS65 score, Glasgow-Blatchford score, Rockall risk score) for the management of patients presenting with UGIB.

Methods: This was a retrospective observational study. We included 283 patients admitted to the gastrointestinal unit at Abha city, southern Saudi Arabia, from November 2017 to October 2019. The study findings were the etiology of UGI bleeding, the endoscopic findings and clinical outcome of UGI bleeding.

Results: Ages ranged from 18 to 97 years old with mean age of 54.5 ± 18.5 years. The majority of patients were males (72%; 203). Melina was the most common presenting symptom, in 66 (49.3%) patients. Diabetes mellitus was the most frequently recorded risk factor for UGIB (53.9%) followed by hypertension (44.9%), and aspirin use (35.7%). Endoscopic hemostatic treatment was applied in 70 patients (24.7%); 4.9% of patients re-bled, and 21 patients (7.4%) died during the study period.

Conclusions: Comorbidities such as hypertension and diabetes, in addition to some medicines including ASA, steroids and NSAIDs were identified as risk factors of upper GIT bleeding among this study casesa list of risk factors for severe UGIB, leading to hospitalization and even death.

Keywords: upper gastrointestinal bleeding; UGIB; hemostatic treatment; re-bleeding; variceal