CLINICAL PROFILE AND OUTCOME OF PATIENTS PRESENTING WITH ACUTE UPPER GI BLEEDING IN A TERTIARY CARE CENTRE OF WESTERN NEPAL

Abstract

Introduction: Acute upper gastrointestinal    (UGI) bleeding   is a common   medical   emergency   which   is associated   with significant morbidity and mortality.  The annual incidence of UGI bleeding varies from 48 to 160 cases per 100,000 populations   in the United States of America (USA), with a mortality rate of 7% to 10%. The aetiology and outcome of UGI bleeding varies significantly in different geographic regions depending on the demographic   and socioeconomic characteristics   of the local population.   This  study  was  done  to  evaluate   the clinical  profile  and  outcome   of patients  presenting   with  acute  UGI bleeding  at a tertiary care centre in Lumbini  zone of Nepal.

Material and Methods: This was a hospital based prospective   observational   study. All the patients  who presented  with  acute UGI bleeding  and fulfilled  the inclusion  criteria  from  1st  August  2013 to 31st  July 2014 were included  in the study. The study was cleared by the ethical review committee of the institute and written informed consent was taken from all the patients.

Results: During the study period, 70 patients fulfilled the inclusion criteria   and were subjected to statistical analysis.  The mean age of patients in the present study was 55.11 ± 19.93 years. The majority of patients (30, 43%) were elder, belonging to the age group of more than 60 years.  There were 55 (79%) male and 15 (21 %) female.  The patients were mostly farmers by occupation   accounting   29 (41 %) cases.  Ethnically, 26 (3 7%) patients of UGI bleeding were from janajati group where majority of them had esophageal varices.  Overall, the peptic ulcer disease was the leading cause of UGI bleeding seen in 26 (37%) patients followed by esophageal   varices seen in 23 (33%) patients.  0 positive was the commonest   blood group which was found in 28 (40%) of our patients.  In our study 44 (63%) patients  were alcohol  consumers  and 37 (53%)  had coexisting   comorbidities   that  added  for the UGI  bleeding  related  complications.   During admission,   7 patients expired causing 10% mortality.

Conclusion: Acute UGI bleeding was commonly seen in older age group patients with male preponderance.   Peptic ulcer disease was the leading cause of the UGI bleeding.   The mortality   rate was found to be 10%. The mortality   also increased   with increasing age and patients with pre-existing co morbidities.

 Journal of Universal College of Medical Science

Vol. 6, No. 1, 2018, Page: 3-7