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.
Onlasyn Ibekenov - Candidate of Medical Sciences, Highest Category Surgeon, Head of the Strategic Block at the National Scientific Center of Surgery Named After A.N. Syzganov, Almaty, Republic of Kazakhstan; E-mail: onlasin72@mail.ru; ORCID: 0000-0001-6605-6435
Abylai Baymakhanov - Candidate of Medical Sciences, Associate Professor, Dean of the Faculty of Postgraduate Education at NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Professor of the Department of Surgical Diseases №1, Almaty, Republic of Kazakhstan; E-mail: baimakhanov.a@kaznmu.kz; ORCID: 0009-0001-0344-1800
Aman Berkinbay - Surgical Resident (2nd year), NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; E-mail: aman_98e@mail.ru; ORCID: 0000-0002-3973-7283
Yermek Zheldibaev - Deputy Director for Surgery at the City Emergency Medical Care Hospital, Highest Category Surgeon, Almaty, Republic of Kazakhstan; E-mail: er.med@mail.ru; ORCID: 0009-0004-0216-1307
Makhsat Duisebekov - Head of the Surgery Department, Hepatobiliary Surgeon at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: makhsatduisebekov@yandex.kz; ORCID: 0009-0001-6697-8074
Nurhat Esenbekov - Highest Category Surgeon at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: esenbekovnurhat4@gmail.com; ORCID: 0009-0007-5324-2117
Tagabay Zhorayev – Senior Lecturer of the Department of General Surgery at NUO "Kazakh-Russian Medical University", Almaty, Republic of Kazakhstan; E-mail: tagabay.zhorayev@bk.ru; ORCID: https://orcid.org/0009-0009-1437-0620
Corresponding author:
Balmagambetova Aru Dyusenovna, PhD, Associate Professor, Department of Normal and Topographic Anatomy with Operative Surgery, Marat Ospanov West Kazakhstan Medical University, Aktobe, Kazakhstan.
Post address: Kazakhstan, 030019, Aktobe, Maresyev street 68.
E-mail: aru.b.84@mail.ru
Phone number: +7 776 760 88 78
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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.2025.27.1.008Похожие публикации:
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