Gastrointestinal bleeding in patients admitted to the intensive care unit

Abstract

Introduction. Gastrointestinal bleeding is a life-threatening condition, with a mortality depending on the cause and severity. The objective of this study was to retrospectively evaluate the epidemiological, clinical and evolutionary aspects of a series of patients diagnosed with gastrointestinal bleeding, admitted to the Intensive Care Unit of the Clinical Emergency Hospital of Bucharest, Romania. Material and methods. A retrospective, descriptive study was carried out, of patients diagnosed with upper and lower gastrointestinal bleeding, admitted to the Intensive Care Unit of the Clinical Emergency Hospital of Bucharest, Romania, between January 1st, 2013 – December 30th, 2018. The clinical variables were collected in a database designed exclusively for the study. Results. We observed that most of the cases were bleedings situated above the Treitz’s angle; the most frequent causes were peptic ulcer disease, followed by variceal hemorrhage and erosive gastroduodenitis. The three most frequent causes of upper gastrointestinal bleeding in our series were peptic ulcer disease, variceal hemorrhage and erosive gastroduodenitis. The global mortality due to gastrointestinal bleeding was 9.8%, with all cases occurring in the group of patients with upper gastrointestinal bleeding. Conclusions. It should be noted that in the group of patients who died, all had hemorrhagic shock at the time of admission, a fact that occurred only in 23% of the cases who survived. This highlights the prognostic value of the hemorrhagic shock on admission.

Keywords

• gastrointestinal bleeding
• hemorrhage
• intensive care unit
• epidemiology
• mortality