Seasonal variation of upper gastrointestinal bleeding
Keywords:
upper digestive hemorrhage, hematemesis, melenemesis, tarry stools, hematocheziaAbstract
Introduction: The High Digestive Hemorrhage represents one of the most frequent causes of morbidity and mortality in the General Surgery Services and it is specifically the first cause of mortality in our service. It constitutes a very frequent medical-surgical emergency.
Objective: to determine the existence of a seasonal pattern in the incidence of HDA in winter and its relationship with risk factors.
Methods: A descriptive and retrospective study was carried out with a longitudinal design in which patients affected by HDA were studied. These patients were assisted at “Dr. Miguel Enriquez Hospital” between December 2017 and January 2020. The study group was composed of all the patients who came to our emergency services with manifestations of bleeding from the upper digestive tract. The sample was made up of 151 patients who presented a diagnosis of HDA at the time of their admission.
Results: The predominant sex was male and the age over 60 years old. The season with the highest incidence of this digestive complication was winter (December, January and February). The risk factors that predominated in our study were toxic habits and ingestion of AINES, ASA. The predominant form of presentation of the HDA were tarry stools, being the Duodenal Peptic Ulcer the main etiology.
Conclusions: Cases with Upper Digestive Bleeding predominated in the winter season and the most frequent risk factors were toxic habits and the use of NSAIDs in relation to the seasonal period.
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References
Eisen G, Dominitz J, Faigel D, et al. An annoted algorithmic approach to upper gastrointestinal bleeding. GastrointestEndosc. 2011;53(7):853-8.
Calleja J, Martínez J. Hemorragia digestiva alta no varicosa. Medicine. 2007;8 (14):725-5.
Almeida Varela R, Pérez Suárez F, Díaz Elías JO, Martínez Hernández JA.Comportamiento de la hemorragia digestiva alta en el Hospital Universitario«Calixto García». Rev Cubana Cir [Internet]. 2011 [citado 15Feb 2020];50(1):4053. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003474932011000100004&lng=es
Ratib S, Fleming KM, Crooks CJ, Aithal GP, West J. 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998-2009: a large population study. J Hepatol [Internet]. 2014 [cited 2020Feb15];60:282-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24128415
Tripathi D, Stanley AJ, Hayes PC. UK guidelines on the management of varicealhaemorrhage in cirrhotic patients. Gut [Internet]. 2015 [cited 2020Feb15];64:1680-704. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25887380
Siau K, Champan W, Sharma N, Tripathi D, Iqobal T, Bhala N. Management of acute upper gastrointestinal bleeding: an update for the general physician. J R Coll Physicians Edinb. 2017;47:218–30.
Trawick E, Yachimski P. Management of nonvariceal upper gastrointestinal tract hemorrhage:Controversies and areas of uncertainty World J Gastroenterol. 2012 March 21;18:1159-65.
DeLaney M., Greene C. Emergency Department Evaluation and Management of Patients with Upper Gastrointestinal Bleeding. Emerg Med Pract. 2015;17:1-18.
Shahrami A., Ahmadi S, Safari S. Full and Modified Glasgow-Blatchford Bleeding Score in Predicting the Outcome of Patients with Acute Upper Gastrointestinal Bleeding; a Diagnostic Accuracy Study. Emergency. 2018; 6:e31.
Galindo F. Hemorragia digestiva. Cirugía Digestiva. 2009; 1:126. Disponible en: http://www.sacd.org.ar
Villanueva C, García J, Hervás A. Hemorragia gastrointestinal. Sección II-Síndromes relevantes en hepato-gastroenterología. Práctica Clínica en Gastroenterología y Hepatología. (s.f) 55-85.
Laine L Clinical Practice. Upper Gastrointestinal Bleeding Due to a Peptic Ulcer. NEngl J Med. 2016 Jun 16;374(24) :2367-76.
Quineche M. Hemorragia digestiva alta en el Hospital Nacional Arzobispo Loayza [tesis]. Perú: Biblioteca de la Facultad de Medicina, Universidad de San Martín de Porres; 2007.
Roller E. Hemorragia digestiva alta en el Hospital Militar [Tesis].Perú: Biblioteca de la Facultad de Medicina, Universidad de San Martín de Porres; 2010.
Palomino A. Experiencias en la endoscopia de urgencia en el Sangramiento Digestivo alto. RevCubMedMilit. 2009;26(2):116-21.
Lopez-Cepero JM, et al. Influencia de los Factores Climáticos en la Incidencia de Hemorragia Digestiva Alta.GastroenterolHepatol. 2005;28(9):540-5.
Rodríguez F, Casamayor Callejas E, GoderichLalan JM, et al. Characterizacion of hospitalized patients due to high digestiva bleeding.Medisan [Internet]. 2011 Ene [ citado 22 Jul 2013];15(1):58-66. Disponible en: http://scielo.sld.cu/scielo.php?scrip=sciarttex&pid=S1029-30192011000100008&ing=es
Rodríguez Fernández Z, A costa González D, Fonng Estrada J, et al. Conducta ante la hemorragia digestiva alta por ulcera gastroduodenal en el anciano: consideraciones actuales. Rev Cubana Cir [interned]. 2010 Mar [citado 22 Jul 2013]; 49(1). Disponible en: http://scielo.sld.cu/scielo.php?scrip=sciarttex&pid=S0034-74932010000100011&Ing=es
Marmo R, Koch M, Cipolletta L, et al. Predicting mortality in non-variceal upper gastrointestinal bleeders: validation of the Italian PNED Score and Prospective Comparison with the Rockall Score.Am J Gastroenterol [Internet]. 2010 [citado 22 J 2013]:105(6):1284-91. Disponible en: http://www.nature.com/ajg/journal/v105/n6/abs/ajg2009687 a. html
Brullet E. Clinical Judgement versus Risk Scores for Predicting Out comein Patients Bleeding fromHight Risk Peptic Ulcer. Preliminary Results of a Prospective Multicenter Study. Gastroenterology. 2009; 136(Suppl1): P-51.
SubhashCh, Hess EP, Agarwal D, et al. External validation of the Glasgow-Blatchford Bleeding Score and the RockallScore in the US setting. American Journal of Emergency Medicine [Interned]. 2012 [citado 25 Sep 2014]; 30(5):673-79. Disponible en: http://mayoclinic.pure.elsevier.com/en/publications/external validation-of the glasgow-blatchfordbleeding score-and-
Al-Assi MT, Genta RM, Kartunen TJ, Granham DY. Ulcer site and complications: relation to Helicobacter pylori infection and use. Endoscopy. 1999;28(2):229-33.
Boulay F, Berthier F, Dahan C, Tran A. Seasonal Variations inVariceal Bleeding Mortality And Hospitalization In France. Am J Gastroenterol. 2012;96:1881-7.
Ibáñez AL, Baeza PC, Guzmán BS, Llanos LO, Zuñiga DA, Chlanale BJ, et al. Tratamiento de la hemorragia digestiva alta de origen no variceal. Evaluación de 10 años de experiencias. RevChil Cir.2008;50(4):370-8.
Sato G, Matsutani S, Maruyama H, Saisho H, Fukusawa T, Et Al. Chronobiological Analysis Of Seasonal Variations Of Variceal Hemorrhage. Hepatology. 2010;28:893-5.
Peng L, Yang J, Lu X, Okada T, Kondo T, Et Al. Effects Of Biological Variations On Platelet Count In Healthy Subjects In China. ThrombHaemost. 2004;91:367- 372
Mavri A, Guzic-salobir B, Salobir-pajnic B, Keber I, Stare J Et Al. Seasonal Variation ofsome Metabolic and Haemostatic Risk Factors in Subjects with and Without Coronary Artery Disease. Blood Coagul Fibrinolysis. 2001;12:359-65.
Ozyilkan E, Köseoglu T, Telatar H. Absence of seasonal fluctuations in peptic ulcer activity. Am J Gastroenterol. 1994;89:955-6.
GarcíaSepulcre MF, MartínezSempere JF, CasellasValdé JA, CarnicerJauregui F. Absence of seasonal variations in peptic ulcer activity and bleeding from peptic ulcer. Am J Gastroenterol.1995;90:1368-9.
Tahri N, Amouri A, Fekih H, El-euch F, Krichen M. Meteorologic Conditions And Esophageal VaricesRuptura. Ann Med Intern 2003;154:509-14.
Soylu A, Oksuzoglu G, Tatar G, Acan Y, Gurlek A. The Effect of Seasons On Variceal Bleeding In Patients with Cirrhosis. Am J Gastroenterol.1996;91:823-4.
9Kurien M, Lobo AJ. Acute upper gastrointestinal bleeding.Clin Med (Lon).2015 Oct;15(5):481-5.15-5-481. PubMed PMID:26430191
11Plaza Santos R, Froilan Torres C, Martin Arranz MD, et al. La hemorragia digestiva alta en el paciente anciano mayor de 80 años. Rev Española de Geriatria y Gerontologia [Interned]. 2012 [citado 25 Sep 2014]; 47(3):110-13. Disponible en:http//www.sciencedirect.com/science/article/pii/S0211139X11002095
Brennan P, Greenberg G, Miall, et al. Seasonal Variations In Arterial Blood Pressure. BMJ. 1982;285:919-23.
Lan JY, Chun S. Management of upper gastrointestinal haemorrhage. J GastroenterolHepatol. 2000;15(Suppl):8-12.
Isemberg Jon I, Soll Andrew H. Úlcera péptica: epidemiología: cuadro clínico y diagnóstico. En: Bennett CJ, PlimF,editors. Cecil. Tratado de Medicina Interna. T 1. 20 ed. México: McGraw-Hill Interamericana;1996. p. 760-1.
Amouretti M, Gouerou H, Capron MH, Hernan H, Colin R. Epidemiology and course of acute upper gastrointestinal hemorrhage in French geographical areas. Eur J gastroenterolHepatol. 2005;12(2):175-81.
Feinman M, Haut E. Upper Gastrointestinal Bleeding. SurgClin North Am. 2014;94:43-53.
Patai A, Jakab Z, Varga F, Dracz L, Rokonozai E, Dobronte Z, et al. Epidemioloy of nonvariceal upper gastrointestinal hemorrhage in Vas Country in Western Hungary. OrvHetil. 2006;139(45):2705-12.
F.J.Montero Pérez. Manejo de la Hemorragia Digestiva Alta en Urgencias, Centrode Salud "ElHiguerón". Distrito SanitariodeCórdoba,emergencias 2002; 14:S19-S27.
Garrido A, Márquez JL, Guerrero FG, Leo E, Pizarro MA, Trigo C. Cambios en la etiología, resultados y características de los pacientes con hemorragia digestiva aguda grave a lolargo del periodo 1999-2005.Rev. Esp. enferm. Dig.[Internet]. May 2007 [ citado 8 May 2017]; 99(5):275-9 Disponible en:http://scielo.isciii.es/pdf/diges/v99n5/original5.pdf
Winograd Lay R, Williams Guerra E, RodríguezÁlvarez D, Ramos Contreras JY, Guisado Reyes Y, Angulo Pérez O, et al. Endoscopia en la atención a pacientes con hemorragia digestiva alta no varicosa. Rev Cubana Med Mil [Internet]. Jun 2015 [citado 8 abril 2016]; 44(2):187-94. Disponible en http://scielo.sld.cu/pdf/mil/v44n2/mil07215.pdf
Jurado Hernández AM, Teresa Galván J, Ruiz-Cabello Jiménez M, Pinel Julián LM. Evolución en la epidemiologia de la hemorragia digestiva alta no varicosadesde el año 1985 hasta 2006. Rev. Esp. enferm. Dig.[Internet]. May 2008 2007 [ citado 8 May 2017]; 100(5):273-7. Disponible en: http://scielo.isciii.es/pdf/diges/v100n5/original4.pdf
CasamayorC, Rodríguez Fernández Z, GoderichLalan JM, et al. Sangrado digestivo alto: consideraciones actuales acerca de su diagnóstico y tratamiento. MEDISAN [Internet]. 2010 Jul [citado 25 Sep 2014]; 14(5), Dieponible en: http://scielo.sld.cu/scielo.php?scrip=sciarttex&pid=S1029-30192013000400008&ing=es
Sung J, Tsoi K, et al. Causes of mortality in Patients with peptic ulcer bleeding: a prospertive cohort study of 10,428 cases. Am J Gastroenterol [Internet] 2010 [citado 22 Jul 2013]; 105:84-9 Disponible en:http://www.nature.com/ajg/journal/v105/n1/abs/ajg2009507a.html
Custodio Lima J, García Montes C, KibuneNagasako C, et al. Performance of the Rockall scoring system in predicting the need for intervention and outcomes in patients with nonvariceal upper gastrointestinal bleeding in Brazilian setting: a prospective study. Digestion [Interned]. 2013 [citado 25 Sep 2014]; 88(4):252-7. Disponible en: http://www.karger.com/Article/Abstract/356313
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