Clinical risk factors of variceal or non-variceal upper gastrointestinal bleeding
Keywords:
Upper gastrointestinal bleeding (UGIB), Variceal bleeding, Non-variceal bleeding, Rick factorsAbstract
Background Upper gastrointestinal bleeding (UGIB) is the most common gastroenterological
emergency and is correlated with a high mortality rate.
Objective To study the risk factors associated with variceal or non-variceal causes of upper
gastrointestinal bleeding.
Methodology This retrospective study (over a 1-year period) took place at the
Somdejphrajaotaksinmaharaj Hospital, and reviewed patients with a medical history of signs &
symptoms (as well as laboratory findings) consistant with UGIB.
Result Of the 171 patients presenting UGIB, 12.8% had variceal bleeding, while 87.2% presented
non-variceal bleeding. Factors associated with non-variceal bleeding included: alcohol
consumption, a history of variceal bleeding, hematemesis, NG lavages confirming bleeding,
hypotension (BP<90/60), cirrhosis, ascites, thrombocytopenia, high AST, ALT with total bilirubin
levels, as well as a low Albumin/globulin ratio. Factors associated with non variceal bleeding
included a history of NSAID and antiplatelet use.
Conclusion This study revealed a new factors associated with variceal bleeding: a low
Albumin/globulin ratio. This factors can be addressed by secondary hospitals. Therefore, patients
can receive their primary treatment before being referred to a specialized center, resulting in
an overall decrease in patient mortality rate.
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