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Prognostic factors associated with upper gastrointestinal bleeding based on the French multicenter SANGHRIA trial

Endoscopy International Open, ISSN: 2196-9736, Vol: 9, Issue: 10, Page: E1504-E1511
2021
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Article Description

Background and study aims Prognostic and risk factors for upper gastrointestinal bleeding (UGIB) might have changed overtime because of the increased use of direct oral anticoagulants and improved gastroenterological care. This study was undertaken to assess the outcomes of UGIB in light of these new determinants by establishing a new national, multicenter cohort 10 years after the first. Methods Consecutive outpatients and inpatients with UGIB symptoms consulting at 46 French general hospitals were prospectively included between November 2017 and October 2018. They were followed for at least for 6 weeks to assess 6-week rebleeding and mortality rates and factors associated with each event. Results Among the 2498 enrolled patients (mean age 68.5 [16.3] years, 67.1% men), 74.5% were outpatients and 21% had cirrhosis. Median Charlson score was 2 (IQR 1-4) and Rockall score was 5 (IQR 3-6). Within 24 hours, 83.4% of the patients underwent endoscopy. The main causes of bleeding were peptic ulcers (44.9%) and portal hypertension (18.9%). The early in-hospital rebleeding rate was 10.5%. The 6-week mortality rate was 12.5%. Predictors significantly associated with 6-week mortality were initial transfusion (OR 1.54; 95%CI 1.04-2.28), Charlson score >4 (OR 1.80; 95%CI 1.31-2.48), Rockall score >5 (OR 1.98; 95%CI 1.39-2.80), being an inpatient (OR 2.45; 95%CI 1.76-3.41) and rebleeding (OR 2.6; 95%CI 1.85-3.64). Anticoagulant therapy was not associated with dreaded outcomes. Conclusions The 6-week mortality rate remained high after UGIB, especially for inpatients. Predictors of mortality underlined the weight of comorbidities on outcomes.

Bibliographic Details

Vincent Quentin; André Jean Remy; Gilles Macaigne; Rachida Leblanc-Boubchir; Jean Pierre Arpurt; Marc Prieto; Carelle Koudougou; Laurent Tsakiris; Denis Grasset; René Louis Vitte; David Cuen; Juliette Verlynde; Khaldoun Elriz; Marie Pierre Ripault; Florent Ehrhard; Mathieu Baconnier; Sofia Herrmann; Nathalie Talbodec; You Heng Lam; Karine Bideau; Laurent Costes; Florence Skinazi; Ivan Touze; Denis Heresbach; Pierre Lahmek; Stéphane Nahon; Christophe Agnello; Frédérique Alabert; Julien Baudon; Jean Kerneis; Thierry Paupard; Morgane Amil; Yves Arondel; Ramuntcho Arotcarena; Karim Aziz; Sandrine Barge; Georges Barjonet; Patrick Zavadil; Lucile Bauguion; Marie Bellecoste; Serge Bellon; Alban Benezech; Aliou Berete; Chantal Berger; Jean Guy Bertolino; Faustine Wartel; Gaëlle Billet; Massimo Bocci; Isabelle Borel; Madina Boualit; Dominique Boutroux; Slim Bramli; Pascale Catala; Claire Charpignon; Jonathan Chelly; Marie Colin; Rémi Combes; Baya Coulibaly; Gaëlle D'Hautefeuille; Hortense Davy; Mercedes De Lustrac; Stéphanie De Montigny-Lenhardt; Jean Bernard Delobel; Anca Stela Dobrin; Weam El Hajjl; Anouk Esch; Roger Faroux; Mathilde Fron; Cécile Garceau; Armand Garioud; Edmond Geagea; Loïc Guerbau; Jessica Haque; Florence Harnois; Frédéric Heluwaert; Clémence Horaist; Mehdi Kaassis; David Zanditenas; Ludovic Lagin; Margot Laly; Oana Zaharia; Antonia Legruyer; Delphine Lemee; Christophe Locher; Dominique Louvel; Henri Lubret; Vincent Mace; Emmanuel Maillard; Magdalena Meszaros; Mohammed Redha Moussaoui; Amélie Nobecourt; Etienne Pateu; Arnaud Pauwels; Agnès Pelaquier; Olivier Pennec; Mathilde Petiet; Fabien Pinard; Vanessa Polin; Gilles Quartier; Isabelle Rosa; Thierry Salvati; Matthieu Schnee; Leila Senouci; Quentin Thiebault; Marie Trompette; Hélène Vandamme; Charlotte Vanveuren; Joseph Vickola

Georg Thieme Verlag KG

Medicine

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