The clinical characteristics of etiologies, diagnoses and treatment of emergency gastrointestinal hemorrhage / 中华内科杂志

ABSTRACT

Objective To investigate the causes, clinical features, treatment and prognosis of gastrointestinal bleeding (GIB) patients in emergency department.Methods To analyze prospectively the clinical data of 168 GIB patients admitted to the emergency department of Peking Union Medical College Hospital during 2006.1-2006.12.Results (1) General data; male female = 1.751 ( 107 61) , mean age 13-87(56.5 ±17.8) years with a peak in 60-69 years.The percentage of old patients was significantly higher than that of young and middle age ( 52.4% vs 19.6% and 28.0% , P = 0.000 ).( 2 ) The incidence of acute gastric mucosal lesion in patients taking non-steroidal antiinflammatory drugs ( NSAIDs) ( 18.5% ) was significantly higher than that in patients not taking( 0.7% , P = 0.000 ).( 3 ) 86.9% ( 146/168 ) of the patients had anemia.(4) More patients who took emergency gastroscopy could be diagnosed than those patients who did not (89.4% vs 58.5% , P =0.000), while no significant difference could be seen between patients who took emergency enteroscopy and patients who had non-emergency gastroscopy (20.0% vs 57.9% , P =0.315).(5)The hemostatic ratio in GIB patients due to peptic ulcer was obviously higher than that in GIB patients due to other causes (86.0% vs 40.7% ,P =0.000).The rate of emergency operation for GIB patients was 1.8%.Conclusions Most of the GIB patients admitted to tertiary general hospitals are elderly males.NSAIDs administration is one of the most important causes of upper GIB.Upper GIB patients should have gastroscopy as soon as possible, while emergency coloscopy is of little significance in cases with lower gastrointestinal hemorrhage.