PDF(Pubmed)
Abstract：
OBJECTIVE: Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department.
METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms.
RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients.
CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.
METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms.
RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients.
CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.
摘要：
目的：消化道出血是一个主要的医疗负担，与显著的发病率和死亡率相关。这项研究旨在评估患病率，临床表现,急诊消化道出血患者的危险因素。
方法：这项回顾性研究是在利雅得的两家三级医院进行的，沙特阿拉伯。回顾了2010年1月至2020年1月期间到急诊科就诊的消化道出血患者的病历。18岁或以上的患者，胃肠道出血（上或下），无论潜在原因，生活方式,出血部位,健康状况,或药物使用，包括在内。人口特征，初始生命体征,病史,体检结果,合并症,药物,实验室和放射学调查，肝病的病因和阶段，管理,并记录并发症。根据出现的症状收集出血部位的内镜检查结果和管理。
结果：共纳入760例患者。平均年龄为62.7±17.8岁，男性占61.4%。最常见的合并症是高血压（54.1%），糖尿病（51.2%），和缺血性心脏病（18.2%）。出血的起源为52％的患者的下胃肠道和48％的患者的上消化道。
结论：下消化道出血比上消化道出血更常见。痔疮,息肉,憩室病,结肠溃疡是下消化道出血的主要危险因素。相比之下,上消化道出血主要由食管静脉曲张引起,胃炎,和消化性溃疡.
方法：这项回顾性研究是在利雅得的两家三级医院进行的，沙特阿拉伯。回顾了2010年1月至2020年1月期间到急诊科就诊的消化道出血患者的病历。18岁或以上的患者，胃肠道出血（上或下），无论潜在原因，生活方式,出血部位,健康状况,或药物使用，包括在内。人口特征，初始生命体征,病史,体检结果,合并症,药物,实验室和放射学调查，肝病的病因和阶段，管理,并记录并发症。根据出现的症状收集出血部位的内镜检查结果和管理。
结果：共纳入760例患者。平均年龄为62.7±17.8岁，男性占61.4%。最常见的合并症是高血压（54.1%），糖尿病（51.2%），和缺血性心脏病（18.2%）。出血的起源为52％的患者的下胃肠道和48％的患者的上消化道。
结论：下消化道出血比上消化道出血更常见。痔疮,息肉,憩室病,结肠溃疡是下消化道出血的主要危险因素。相比之下,上消化道出血主要由食管静脉曲张引起,胃炎,和消化性溃疡.
