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Characterization of patients with non-varicose upper GI bleeding at a Level 3 Hospital in Cundinamarca, Colombia

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Rivera H D.
Martínez M J.D.
Tovar C J.R.
Garzón O M.A.
Hormaza A N.
Lizarazo J.I.
Marulanda G J.C.
Molano V J.C.
Rey Tovar M.H.




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Upper gastrointestinal tract bleeding is a common emergency whose most common etiology is a peptic ulcer. Restoration of intravascular volume and blood pressure management are priorities before identifying the cause of bleeding. After initial resuscitation and after hemodynamic stabilization has been achieved, an esophagogastroduodenoscopy (EGD) should be performed to identify the cause of bleeding and determine the treatment needed. This is a study performed at a third level referral hospital in Cundinamarca, Colombia. Materials and Methods: This is a retrospective study of data from electronic medical records of adult patients admitted to the emergency room of the Hospital Universitario de la Samaritana (HUS) because of upper gastrointestinal tract bleeding which ahd been diagnosed because of hematemesis, melena, rectal bleeding and/or anemia. Patients all underwent EGD between April 2010 and April 2011. Results: 385 patients with upper gastrointestinal tract bleeding were seen during the study period, but 100 were excluded because of bleeding secondary esophageal varices, incomplete clinical histories and lower gastrointestinal bleeding. A total of 285 patients were included. 69.1 % were older than 60 years, 73.3 % had hypertension, 55.1 % reported use of inflammatory drugs (NSAIDs) and aspirin (ASA), 19.6 % reported previous bleeding episodes, and 17.9 % had hemodynamic instability. 63 patients (22.1 %) required endoscopic hemostasis, and 32 (11.2 %) experienced rebleeding. Overall mortality reported was 13.1 % of which 55.3 % were men. Mortality attributable to gastrointestinal bleeding was 3.1 %. Conclusions: The majority of patients served by the HUS with upper GI bleeding are adults over 60 years. Peptic ulcers remain the most common diagnosis associated with the use of NSAIDs and ASA. The mortality rate is comparable to international standards. © 2013 Asociaciones Colombianas de Gastroenterología.
Palabras clave
Esophagogastroduodenoscopy , Hemostasis , Mortality , Upper GI bleeding