NON-VARICOSE BLEEDING FROM THE UPPER GASTROINTESTINAL TRACT
Introduction. Non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the most critical issues in emergency surgery. This pathology is characterized by a high prevalence and significant mortality rates, especially among elderly patients and individuals with comorbid conditions.
Aim. To study the treatment outcomes of patients with non-variceal upper gastrointestinal bleeding.
Materials and methods. A retrospective study was conducted among n = 667 patients who received inpatient treatment at the surgical department of the City Emergency Hospital in Almaty from January 1, 2019, to December 31, 2023. Mean values (M ± m) and differences between arithmetic means were assessed using Student’s t-test. The relationship between clinical parameters and outcomes was evaluated using the chi-square (χ²) test. Risk factors for adverse outcomes (mortality, rebleeding, need for surgical treatment) were analyzed using logistic regression. The impact of factors was assessed by calculating the odds ratio (OR) with a 95% confidence interval (95% CI). A p-value < 0.05 was considered statistically significant.
Results. The primary causes of bleeding were acute ulcers (60.4%), Mallory-Weiss syndrome (20.4%), chronic ulcers (13.2%), and bleeding of unknown etiology (6.0%). According to the Forrest classification, the most common form was IIB (54.5%). The overall rebleeding rate was 6.9%, while the total mortality rate was 3.6%. Mortality rates by etiology were as follows: acute ulcers – 2.7%, chronic ulcers – 5.6%, Mallory-Weiss syndrome – 0.7%, and bleeding of unknown etiology – 17.5%. The average surgical intervention rate during the study period was 2.8%.
Conclusions. Thus, non-variceal upper gastrointestinal bleeding remains a pressing issue in gastroenterology and surgery, requiring a comprehensive approach to diagnosis and treatment. The study confirmed the high prevalence of peptic ulcer disease, Mallory-Weiss syndrome, and erosive lesions as leading causes of bleeding. The main risk factors for NVUGIB include the use of anticoagulants, nonsteroidal anti-inflammatory drugs, and cardiovascular diseases, highlighting the necessity of careful medication management in patients at high risk of bleeding.
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Ibekenov O.T., Baymakhanov A.N., Berkinbay A.B., Zheldibaev Ye.M., Duisebekov M.K., Esenbekov N.B., Zhorayev T.S. Non-varicose bleeding from the upper gastrointestinal tract // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (1), pp. 66-74. doi 10.34689/SH.2025.27.1.008Related publications:
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