CLINICAL INTERVENTION AND OUTCOMES IN HIGH-RISK PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING

Abstract

OBJECTIVE: To determine the frequency of clinical interventions and outcomes in high-risk patients presenting with upper gastrointestinal (GI) bleeding.

METHODOLOGY: This cross-sectional descriptive study was conducted at the Department of Medicine, Indus Medical College Hospital over six months. A total of 119 patients aged 30–70 years of either gender with a history of upper GI bleeding (black/tarry stools for three days or hematemesis for ≥1 hour) were included. Data regarding demographics, comorbidities, and laboratory parameters were recorded. Clinical interventions (blood transfusion, endoscopy) and outcomes (discharged, referred, death) were assessed. Mean ± standard deviation (SD) was calculated for quantitative variables, while median (IQR) was used for non-normal data after Shapiro-Wilk testing. Post-stratification chi-square/Fisher’s exact test was applied, with p ≤0.05 considered statistically significant.

RESULTS: The mean age was 52.4 ± 10.6 years, with 61.3% males. Anemia (56.3%), raised ESR (53.8%), raised C-reactive protein (50.4%), and Helicobacter pylori infection (52.1%) were the most frequent findings. Blood transfusion was required in 59.7% and endoscopy was performed in 69.7% of patients. Most patients were discharged (72.3%), while 17.6% were referred and 10.1% died. Hypoalbuminemia, anemia, and hepatitis C infection were significantly associated with poor outcomes (p ≤0.05).

CONCLUSION: Upper GI bleeding in high-risk patients is associated with significant morbidity and mortality. Early endoscopic intervention and prompt correction of anemia are crucial for improving outcomes. Identification of high-risk factors such as hypoalbuminemia and chronic liver disease aids in timely management and risk stratification.