PATTERN AND OUTCOME OF UPPER GASTROINTESTINAL BLEEDING IN THE ADULT EMERGENCY DEPARTMENT OF ST. PAUL'S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA: FIVE MONTH CROSS-SECTIONAL STUDY.

Abstract

ABSTRACT Background: Upper gastrointestinal bleeding (UGIB) is a common emergency gastrointestinal problem that has substantial mortality and healthcare resources use. Acute gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalization. There is no local data on the clinical presentation, the magnitude, causes, and outcomes of UGIB, emergency department in Ethiopia Objective: Therefore, this study aims to determine the patterns and outcomes of upper gastrointestinal bleeding in the emergency department of St. Paul’s hospital millennium medical college (SPHMMC), Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted at the SPHMMC emergency department. All patients admitted to SPHMMC ED from April 01, 2022, to August 31, 2022, who qualify or are already qualified and on chronic follow-up are the study population. The minimum sample size was 184 and data was collected from medical records by using a structured questionnaire checklist and was analyzed by SPSS version 26.0. Result: From the total of 184 patients with a median (IQ) age of 35 (±14.37). The majority (63.6%) of them were males. Varices are the most common cause of UGIB seen in 42.9%, followed by duodenal ulcer disease at 24.2%. The pattern of presentation to ED, 49.5% had hematemesis,1.1 % with Melena and concomitant hematemesis with melena were the presenting manifestations in 49.5% of patients. The proportion of death in this study was 2.7%, Multivariable analysis showed that AIMS-65 scores of more than 2 were high risk and more likely to die [AOR (95%CI) = 0.067(0.007,0.652)], having comorbidity, patients had higher odds of death [AOR (95%CI) = 1.409(1.038,1.914)]. Having grade 3 and 4 varices at initial endoscopy has higher odds ratio as compared to those whose grade 1 and 2 varices [AOR (95%CI) = 0.253 (0.073,0.88)]. Conclusion: In this study most patients with UGIB presented with Hematemesis 49.5% or both Hematemesis and Melena 67.4% had co-morbidity; Liver disease is the most common co-morbidity found in 46.7%.In this study also varices were the common cause of UGIB which was seen in 79 patients (43%) followed by duodenal ulcers seen in 27(14.7%) of patients with UGIB Varices & ulcers accounted for 24(13%) patients and overall mortality was 2.7%,this mortality is associated with comorbidity, the highest risk score of AIMS-65, and grade of varices. Keywords: Pattern, Outcome, Risk factor.