• 作者：¨¢ngeles P¨¦rez Aisa ; Javier Nuevo ; Anibal Alej ; ro L¨®pez Morante ; ¨¢ngel Gonz¨¢lez Galilea ; Carlos Martin de Argila ; David Avi?oa Arreal ; Faust Feu ; Fern ; o Borda Celaya ; Javier P. Gisbert ; Francisco P¨¦rez Roldan ; Jos¨¦ Manuel Gonzalvo Sorribes ; Jos¨¦ Mar¨ªa Palaz¨®n Azor¨ªn ; Marta Ponce Romero ; Manuel Castro Fern¨¢ndez ; M. Vega Catalina Rodriguez ; Sonia Gallego Monta?¨¦s ; Xavier Calvet ; Luis Rodrigo Saez ; Miguel Montoro Huguet ; Yanira Gonz¨¢lez M¨¦ndez ; et al.
• 关键词：Hemorragia digestiva alta ; ENERGIB ; Manejo clí ; nico ; Resultados ; Pronó ; stico
• 刊名：Gastroenterolog¨ªa y Hepatolog¨ªa
• 出版年：2012
• 出版时间：August-September, 2012
• 年：2012
• 卷：35
• 期：7
• 页码：468-475
• 全文大小：412 K

Background

Mortality related to nonvariceal upper gastrointestinal bleeding (NVUGIB) has not changed. More information is needed to improve the management of this entity. The aims of this study were: a) to determine the characteristics of bleeding episodes, b) to describe the clinical approaches routinely used in NVUGIB, and c) to identify adverse outcomes related to endoscopic or medical treatments in Spain.

Methods

The European survey of nonvariceal upper GI bleeding (ENERGiB) was an observational, retrospective cohort study on NVUGIB with endoscopic evaluation carried out across Europe. The present study focused on Spanish patients in the ENERGiB study. The patients were managed according to routine care. The mean and standard deviation were calculated for quantitative variables and absolute and relative frequencies were calculated for categorical variables.

Results

Patients (n=403) were mostly men (71 % ), with a mean age of 65 years, and co-morbidities (62.5 % ). Most of the patients were managed by gastroenterologists (57.1 % ) or internal medicine teams (25.1 % ). A proton pump inhibitor was used empirically in 80 % before endoscopy. Bleeding persistence occurred in 6.4 % and recurrence in 6.7 % . The mortality rate at 30 days was 3.5 % .

Conclusions

This study contributes to the characterization of Spanish patients and NVUGIB episodes in a real clinical setting and identifies the routine management of this entity, which is in line with the standards proposed by recent clinical practice guidelines. A notable finding was that age and the number of comorbidities in NVUGIB patients were increasing. These factors could explain the persistent mortality rate, despite the evident advances in the management of this entity.