Descriptive Study Of Patients With Upper Gastrointestinal Bleeding From January 2014 To December 2018 In A Hospital

Objective:To understand the incidence of upper gastrointestinal bleeding in Yan'an University Affiliated Hospital,to establish a database of clinical data on the disease in the past five years.It provides data support and theoretical basis for patient management and patient education,prognosis,etiology and prevention of acute upper gastrointestinal hemorrhage.Methods:General data(gender,age,occupation,residence,marital status)and clinical data(etiology,inducement,season and time of onset,blood loss)of patients with upper gastrointestinal bleeding admitted to the affiliated hospital of Yan'an University from January 2014 to December 2018 were retrospectively collected from the medical record browser,a total of 1220 patients with upper gastrointestinal bleeding were collected after excluding the unqualified cases.Statistics of the general situation of patients with upper gastrointestinal bleeding in Yan'an University Affiliated Hospital,including gender composition,age distribution,occupational characteristics,origin of residence and marital status,to analyze the etiology composition of patients with upper gastrointestinal bleeding in our hospital and the relationship between the common etiology,gender,age,season of onset and blood loss.Understand the law of change by longitudinal comparison of the common causes of upper gastrointestinal bleeding for five years.Finally,the causes and prognosis of upper gastrointestinal bleeding were analyzed.Results:1.There were 923 male patients(75.7%)and 297 female patients(24.3%)with upper gastrointestinal bleeding.Farmers accounted for 51.1% of patients with gastrointestinal bleeding,cadres accounted for a small number of 12.2%,students accounted for at least 1.4%.Most of the patients admitted to the affiliated hospital of Yan'an University due to gastrointestinal bleeding were from Baota district(392 patients,accounting for 32.1%),followed by Zichang county(10.3%)and Ansai county(9.8%),while Luochuan county,Huangling county and Huanglong county have fewer patients.The proportion of married patients was 71.9%,much higher than that of unmarried patients(5.7%).The average age of patients with upper gastrointestinal bleeding was 53.39±15.79 years old,ranging from 8 to 93 years old.,the distribution was mostly from 50 to 59 years old,accounting for 24.3%,followed by 40 to 49 and 60 to 69 years old,accounting for 20.2% and 18.7%,respectively.2.Nearly five years in our hospital,the first cause of acute upper gastrointestinal bleeding was esophagogastric variceal bleeding,accounting for 44.3 %,and the second major disease was peptic ulcers,accounting for 28.8 %,followed by gastric cancer,acute gastric mucosal lesions and mallory-weiss syndrome,the proportions were 8.0%,6.3% and 5.0% respectively.The top five causes accounted for 92.4% of the total number of upper gastrointestinal bleeding.Duodenal ulcer was the most common peptic ulcer,accounting for 44.4%.3.Through statistical analysis,there were significant gender differences in the five common causes of gastrointestinal bleeding(P<0.05),with more males than females.The difference in age distribution was also statistically significant(P<0.05),and the pairwise comparison of etiological composition among different age groups was also statistically significant(P<0.05).Esophageal gastric varices,peptic ulcers,mallory-weiss syndrome were frequently showed in the middle-aged,gastric cancer and acute gastric mucosa lesion were seen more at old people.4.There was no statistically significant difference in the incidence season of the five common causes(P>0.05),but there was statistically significant difference in the amount of bleeding of the five common causes(P<0.05).Pairwise comparison of etiological composition ratio between different amounts of bleeding was statistically significant(P<0.05),the causes of massive upper gastrointestinal bleeding are usually found in esophageal and gastric varices and mallory-weiss syndrome.5.A longitudinal comparison of the four common causes of acute upper gastrointestinal bleeding over the past five years shows that Esophageal gastric varices has always been the leading cause of acute gastrointestinal bleeding in Yan'an University Affiliated Hospital,and the rate of this cause increased from 44.8 % of the total number of cases in 2014 to 52.4 % in 2018.Whereas the proportion of peptic ulcers is on the decline over time,accounting for 35.9 % of the total number of cases in 2014 and 30.5 % in 2018.6.Most of the patients with acute upper gastrointestinal bleeding had no obvious inducement.Those with inducement were mostly eating improperly and taking non-steroidal anti-inflammatory drugs,with 227 cases(18.6 %)and 41 cases(3.4 %).7.In the five years,there were 27 people died of acute upper gastrointestinal bleeding,the mortality rate was 2.2 %,and the 85.2% cause of death was esophageal and gastric varices.Conclusion:Through discussion and analysis: The upper gastrointestinal bleeding patients hospitalized in Yan'an University Affiliated Hospital were mostly male,with an average age of 53.39 ± 15.79 years,concentrated in middle-aged people,and mostly farmers,with a mortality rate of 2.2 %.In most patients,there is no obvious cause of upper gastrointestinal bleeding,some of the obvious causes are related to improper diet and taking non-steroidal anti-inflammatory drugs.The esophagogastric variceal bleeding has always been the leading cause of acute gastrointestinal bleeding in Yan'an University Affiliated Hospital,and the rate of this cause increased year by year,whereas the proportion of peptic ulcers is on the decline over time.There are obvious gender and age differences in the five common causes.the man is more than women.The gastrointestinal bleeding caused by esophagogastric variceal bleeding,peptic ulcer,and mallory-weiss syndrome is more common in middle-aged people.The bleeding caused by gastric cancer and acute gastric mucosa lesions is more common in the elderly.There are no obvious differences in the onset seasons of the five common causes,but the amount of bleeding caused by different,the causes of massive upper gastrointestinal bleeding are usually found in esophageal and gastric varices and mallory-weiss syndrome.