Upper Gastrointestinal Bleeding (UGIB)
Conditions
Brief summary
* To study the association between non-variceal UGIB and the use of NSAIDs, VKAs, DOACs and antiplatelet therapy. * To compare the severity of bleeding related to specified drugs. * To determine risk factors associated with non-variceal UGIB.
Detailed description
Upper gastrointestinal bleeding (UGIB) carries a high mortality, especially in elderly patients having co-morbidities, and the incidence of non-variceal and variceal bleeding is reported to be 3.5% and 15%, respectively. Atrial fibrillation, deep vein thrombosis, pulmonary embolism, and other conditions require anticoagulation, non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet therapy putting the patients at high risk of hemorrhage. The latest American Heart Association (AHA) report on cardiovascular diseases suggests a doubling of the prevalence of atrial fibrillation by 2030 compared to 2010. The need to institute anticoagulation for this condition, both as primary and secondary prevention, will automatically increase the number of UGIB cases. An improvement in this regard has occurred with the advent of direct oral anticoagulants (DOACs) which have been shown to be non-inferior to vitamin K antagonists (VKAs). In the event of UGIB, the Rockall score is a valid prediction score, repeatedly confirmed to assess the risk of patients with non-variceal bleeding. The management of UGIB is commonly adapted according to this score. Identifying high-risk patients who may benefit from longer hospitalization is crucial.
Interventions
PROCEDUREUpper endoscopy
All patients will do gastroscopy (upper endoscopy) within the first 24 hour of admission and specific elements of bleeding
Sponsors
Assiut University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adult patients (aged 18 years and above) presented with signs and symptoms of UGIB (hematemesis and/or melena)
Exclusion criteria
* Variceal bleeding * Age below 18 years * Pregnant women * Consent refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association between non-variceal UGIB and the use of different drugs | through study completion, an average of 1 year | observation the association between the incedience of Non-variceal upper Gastrointestinal Bleeding and the use of NSAIDs, VKAs, DOACs and antiplatelet therapy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The severity of Non-variceal bleeding related to specified drugs. | through study completion, an average of 1 year | To compare the severity of Non-variceal bleeding related to specified drugs, according to Rockall Score |
| Risk factors associated with non-variceal upper gastrointestinal bleeding | through study completion, an average of 1 year | We will determine risk factors associated with With non-varicreal gastrointestinal bleeding, such as demographic data, smoking , co-morbidities ، dose and duration of specified drugs, and presence of h pylori infection. |
Contacts
Primary ContactNada Abdelfattah Ahmed Abdelatty, Resident doctor
Backup ContactMohammed Ezz-Eldin Abd-Elmoneim, Lecturer
Outcome results
None listed