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Analysis of the patients with nonvariceal upper gastrointestinal bleeding and comparison of Rockall and Glasgow-Blatchford scores

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Abstract

Background

Nonvariceal upper gastrointestinal bleeding (UGB) has important morbidity and mortality. Predicting high-risk patients for mortality and rebleeding is necessary for a treatment plan. In the present study, we aimed to define the epidemiological and etiological characteristics of patients presenting with nonvariceal UGB and to observe mortality and morbidity rates. We also aimed to compare Rockall and Glasgow-Blatchford scoring systems in predicting rebleeding and mortality.

Methods

Subjects presenting with nonvariceal UGB over a 3-year period were included. Demographic characteristics, symptoms, and signs on physical examination, laboratory data, endoscopic signs and diagnosis, interventions during hospitalization and follow-up period were recorded. Glasgow-Blatchford and Rockall scores were calculated for every participant at the first day of the admission.

Results

A total of 709 patients were enrolled in the study. A total of 490 of them (69.1%) were men. The mean age of the women and men was 60.7±1.2 and 58.6± 0.7 years, respectively. Melena was the most common presenting symptom. Duodenal ulcer (31%), gastric ulcer (20.7%), and erosive disease (17.6%) were the most common causes of bleeding. History of use of aspirin and/or nonsteroidal anti-inflammatory drug use were present in 63.7% of the subjects. All patients were followed up for 30th-day mortality. Overall, rebleeding and mortality rates were 11% and 7%, respectively. A Rockall score greater than 6 was the most important predictor of mortality (odds ratio:39.1) and rebleeding (odds ratio:4.7).

Conclusion

Nonvariceal UGB patients with a Rockall score greater than 6 should undergo aggressive endoscopic treatment and inpatient care.

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Authors and Affiliations

  1. Department of Internal Medicine, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey

    Gulali Aktas

  2. Department of Gastroenterology, Ondokuz Mayis University, Faculty of Medicine, 55100, Samsun, Turkey

    Muge Ustaoglu, Tulay Bakir, Rahmi Aslan, Fikret Goren & Ahmet Bektas

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  1. Gulali Aktas
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  2. Muge Ustaoglu
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  3. Tulay Bakir
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  4. Rahmi Aslan
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Correspondence to Muge Ustaoglu.

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Conflict of interest

GA, MU, TB, RA, FG, and AB declare no competing interests.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Ethical approval

The study was approved by the Ethics Committee of the Ondokuz Mayis University, Faculty of Medicine, and complied with the Declaration of Helsinki.

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Aktas, G., Ustaoglu, M., Bakir, T. et al. Analysis of the patients with nonvariceal upper gastrointestinal bleeding and comparison of Rockall and Glasgow-Blatchford scores. Indian J Gastroenterol 41, 576–582 (2022). https://doi.org/10.1007/s12664-022-01290-z

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