STUDY OF CLINICAL AND ENDOSCOPIC PROFILE OF UPPER GASTROINTESTINAL BLEED IN A TERTIARY CARE CENTER – GRH, MADURAI

Rajendran Pugazhvanan; Nagarajan Ragavan

Volume : VII, Issue : X, October - 2017

STUDY OF CLINICAL AND ENDOSCOPIC PROFILE OF UPPER GASTROINTESTINAL BLEED IN A TERTIARY CARE CENTER – GRH, MADURAI

Rajendran Pugazhvanan, Nagarajan Ragavan

Abstract :

BACKGROUND

Upper gastrointestinal bleed is a medical emergency commonly encountered in medical practice. Even with medical advances the mortality among them tend to be 5–10%. The epidemiology of upper gastrointestinal bleed varies among population and there is a paucity of data.²

AIM OF THE STUDY

This study was planned with an aim to identify clinical and endoscopic profile of patients with upper gastrointestinal bleed coming to our hospital and to study the factors associated with etiology, morbidity and mortality.

SETTINGS AND DESIGN

Descriptive Observational study

MATERIALS AND METHODS

This study is conducted at government Rajaji hospital, Madurai which is a tertiary care referral center in southern Tamilnadu. Sample of 100 patients presenting with upper gastrointestinal bleed were included in the study . Patients were assessed clinically, stabilised, and subjected to endoscopic evaluation. The results are documented and interpreted and statistical analysis done.

STATISTICAL ANALYSIS

One way ANOVA, Pearson correlation and Chi square test.

RESULTS

This study revealed variceal bleed as the most common finding constituting 36% of study population. Peptic ulcer disease was the second common cause with 25% of study population. Other findings include Erosive gastroduodenal lesions 10%, Neoplasm 7%, Mallory–Weiss tear 6%, Esophagitis 3%, other lesions 2%. No identifiable lesion was recorded in 11% of study population. Factors associated with mortality were presence of comorbidities like renal failure and cardiac failure. Rebleed and mortality were associated with Rockall score of >7 and Glasgow Blatchford score of >5 which were statistically significant. Rebleed and mortality was significantly absent in patients with Rockall score of 0–3 and Glasgow Blatchford score of 0.⁴

CONCLUSIONS

Variceal bleed is the leading cause of upper gastrointestinal bleed in this study. Renal failure and cardiac diseases are associated with higher mortality. Rockall score of 0–3 and Glasgow Blatchford score of 0 shows better prognosis among study population. ⁹