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Med Sci Monit. 2018 Oct 6;24:7119-7129. doi: 10.12659/MSM.909560.

Peptic Ulcer Is the Most Common Cause of Non-Variceal Upper-Gastrointestinal Bleeding (NVUGIB) in China.

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Department of Gastroenterology, The 2nd Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China (mainland).
Institute of Digestive Diseases, Chinese PLA General Hospital, Beijing, China (mainland).
Department of Gastroenterology, Beijing Tian Tan Hospital, Beijing, China (mainland).
Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China (mainland).
Department of Gastroenterology, Xi'an Central Hospital, Xi'an, Shanxi, China (mainland).
Department of Gastroenterology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Department of Gastroenterology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland).
Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China (mainland).
Department of Gastroenterology, First People's Hospital of Foshan, Foshan, Guangdong, China (mainland).


BACKGROUND This study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012. MATERIAL AND METHODS Hospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software. RESULTS Total of 2977 hospitalized patients from 8 medical centers were included. A total of 95.47% (2842/2977) of patients were admitted to a general ward, 3.53% (105/2977) were admitted to an emergency ward, and 1.00% (31/2977) were admitted to an intensive care unit. Peptic ulcer remained the most common cause of NVUGIB (73.26%), but there was a declining trend in its constituent ratio, from 2008 to 2012. A total of 14.41% (429/2977) of patients had co-morbid conditions, 92.85% (2764/2977) used proton-pump inhibitors (PPIs) prior to endoscopic treatment, 19.65% (585/2977) underwent emergency endoscopy, and 23.45% (698/2977) received a transfusion of red blood cell suspensions. A total of 5.34% (159/2977) underwent endoscopic therapy, with a treatment rate of 16.9% in high-risk peptic ulcer patients (96/568). A total of 7.69% (237/2977) were administered aspirin, of whom 32.50% (77/237) resumed aspirin intake after gastrointestinal bleeding was controlled. The median length of hospitalization was 8 days (IQR, 5-11) and the mortality rate was 1.71% (51/2977). CONCLUSIONS Peptic ulcer was still the most common cause of NVUGIB in China. The proportion of patients with high-risk peptic ulcer bleeding who received endoscopic therapy was 16.9%. Only 19.65% of NVUGIB patients underwent emergency endoscopy.

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