BACKGROUND: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency associated with substantial morbidity and mortality. Despite advances in endoscopic and pharmacological treatment during the past two decades, the incidence of mortality associated with NVUGIB has remained relatively constant. AIM: To report outcomes and predictive factors for bleeding continuation/re-bleeding and mortality of NVUGIB in clinical practice in different European countries. METHODS: This observational, retrospective cohort study (NCT00797641; ENERGIB) was conducted in Belgium, Greece, Italy, Norway, Portugal, Spain and Turkey. Eligible patients were hospitalised (new admissions or inpatients), presenting with overt NVUGIB with endoscopy from 1 October to 30 November, 2008. Patients were managed according to routine care, and data regarding bleeding continuation/re-bleeding, pharmacological treatment, surgery and mortality during 30-days after the initial bleed were collected. A multivariate analysis of clinical factors predictive of poor outcomes was conducted. RESULTS: Overall, 2660 patients (64.7% men; mean age 67.7 years) were evaluable. Significant differences across countries in bleeding continuation/re-bleeding (range: 9-15.8%) or death (2.5-8%) at 30 days were explained by clinical factors (number of comorbidities, age > 65 years, history of bleeding ulcers, in-hospital bleeding, type of lesion or type of concomitant medication). Other factors (country, size of hospital, profile of team managing the event, or endoscopic/pharmacological therapy received) did not affect these outcomes. Similar predictors were observed in patients with high-risk stigmata. CONCLUSION: Differences in the outcomes of nonvariceal upper gastrointestinal bleeding in clinical practice across some European countries are explained mainly by patient-related factors, and not by management factors.
BACKGROUND:Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency associated with substantial morbidity and mortality. Despite advances in endoscopic and pharmacological treatment during the past two decades, the incidence of mortality associated with NVUGIB has remained relatively constant. AIM: To report outcomes and predictive factors for bleeding continuation/re-bleeding and mortality of NVUGIB in clinical practice in different European countries. METHODS: This observational, retrospective cohort study (NCT00797641; ENERGIB) was conducted in Belgium, Greece, Italy, Norway, Portugal, Spain and Turkey. Eligible patients were hospitalised (new admissions or inpatients), presenting with overt NVUGIB with endoscopy from 1 October to 30 November, 2008. Patients were managed according to routine care, and data regarding bleeding continuation/re-bleeding, pharmacological treatment, surgery and mortality during 30-days after the initial bleed were collected. A multivariate analysis of clinical factors predictive of poor outcomes was conducted. RESULTS: Overall, 2660 patients (64.7% men; mean age 67.7 years) were evaluable. Significant differences across countries in bleeding continuation/re-bleeding (range: 9-15.8%) or death (2.5-8%) at 30 days were explained by clinical factors (number of comorbidities, age > 65 years, history of bleeding ulcers, in-hospital bleeding, type of lesion or type of concomitant medication). Other factors (country, size of hospital, profile of team managing the event, or endoscopic/pharmacological therapy received) did not affect these outcomes. Similar predictors were observed in patients with high-risk stigmata. CONCLUSION: Differences in the outcomes of nonvariceal upper gastrointestinal bleeding in clinical practice across some European countries are explained mainly by patient-related factors, and not by management factors.
Authors: Nl de Groot; Mgh van Oijen; K Kessels; M Hemmink; Blam Weusten; R Timmer; Wl Hazen; N van Lelyveld; Wl Curvers; Lc Baak; R Verburg; Jh Bosman; Lrh de Wijkerslooth; J de Rooij; Ng Venneman; M Pennings; K van Hee; Rch Scheffer; Rl van Eijk; R Meiland; Pd Siersema; Aj Bredenoord Journal: United European Gastroenterol J Date: 2014-06 Impact factor: 4.623
Authors: Mohamed Hussein; Durayd Alzoubaidi; Alvaro de la Serna; Michael Weaver; Jacobo O Fernandez-Sordo; Johannes W Rey; Bu'Hussain Hayee; Edward Despott; Alberto Murino; Sulleman Moreea; Phil Boger; Jason Dunn; Inder Mainie; David Graham; Dan Mullady; Dayna Early; Krish Ragunath; John Anderson; Pradeep Bhandari; Martin Goetz; Ralf Kiesslich; Emmanuel Coron; Enrique R de Santiago; Tamas Gonda; Laurence B Lovat; Rehan Haidry Journal: United European Gastroenterol J Date: 2020-06-26 Impact factor: 4.623
Authors: A Koch; L Buendgens; H Dückers; J Bruensing; M Matthes; J Kunze; H H Lutz; T Luedde; J J W Tischendorf; C Trautwein; F Tacke Journal: Med Klin Intensivmed Notfmed Date: 2013-03-17 Impact factor: 0.840