Risk factors for upper gastrointestinal bleeding requiring hospitalization

Objective: To analyze the causes of upper gastrointestinal bleeding (UGIB) in northeast China. Methods: In-patients with hematemesis, melena, and/or hematochezia who underwent upper endoscopy with an identified source at The First Hospital of Jilin University were enrolled in this study. The cause of bleeding, patient age, clinical features and drugs were retrospectively evaluated. Results: A total of 1,740 patients were included in this study. Among these patients, mean age was 57 ± 13 years and 1340 (77%) were male. Bleeding from varices was more common than from ulcers among patients with hematemesis with/without melena (47% vs. 30%, P<0.01). Varices were the most common cause of gastrointestinal bleeding in 672 (39%) patients, followed by peptic ulcer disease in 600 (34%) patients. One hundred twenty (7%) patients had acute UGIB associated with drugs, in which nonsteroidal anti-inflammatory drugs (NSAIDs) were identified as the main drugs associated with UGIB. Among these 120 patients, 60 (50%) patients used aspirin, 9 (8%) patients used aspirin combined with clopidogrel, 30 (25%) patients used Chinese herbal medicines, 18 (15%) used aminopyrine-phenacetin, and 12 (10%) patients used corticosteroids. Conclusion: Varices was the most common cause of UGIB, followed closely by ulcers. The proportion of patients who had cancer was higher in the elderly group. The incidence of varices was higher in the middle-aged group. In addition, 7% of patients who had UGIB took NSAIDs (aspirin), clopidogrel, or Chinese herbal medicines.