Analysis Of The Etiology And Risk Factors Of Gastrointestinal Bleeding

Purpose:The purpose is to retrospectively analyze the etiology of patients with gastrointestinal hemorrhage in the Third Affiliated Hospital of Nanchang University in recent years and the relationship between related factors,so as to provide a basis for the etiological research and prevention of gastrointestinal hemorrhage.Methods:The electronic medical record system of the Third Affiliated Hospital of Nanchang University collected clinical data of patients with gastrointestinal bleeding admitted from January 2015 to June 2020,including hospitalization number,name,gender,age,admission date,smoking history,drinking history,Hemoglobin count,presence or absence of blood transfusion,presence or absence of non-steroidal anti-inflammatory drugs,antiplatelet drugs and anticoagulant drug application history,presence or absence of surgical intervention,etc.,and the gastrointestinal endoscopy report of the selected candidates was collected.According to the inclusion and exclusion criteria,a total of 1,319 patients were enrolled.All data were analyzed statistically using SPSS25.0 to explore the etiology of gastrointestinal bleeding and the relationship between related factors.Results:1.Among patients with gastrointestinal bleeding,there were 865 males,accounting for 65.6%,and 454 females,accounting for 34.4%,with a male-to-female ratio of 1.91:1.The age range of patients with gastrointestinal bleeding is 13-97 years,with an average age of 61.17±19.28 years.The average age of male patients with gastrointestinal bleeding is 57.49±19.44 years,and the average age of female patients with gastrointestinal bleeding is 68.18±16.90 years,Females are older than males.Most of the patients came from the elderly group,accounting for 47.9%,followed by the middle-aged group,accounting for 37.4%,and the youth group and juvenile group accounting for 13.6% and 1.1%,respectively.2.Among patients with gastrointestinal bleeding,upper gastrointestinal bleeding accounted for 80.1%(1057/1319),and lower gastrointestinal bleeding accounted for 19.9%(262/1319).The first cause of upper digestive bleeding is peptic ulcer,accounting for 37.7%,followed by rupture of esophageal and gastric varices,and acute hemorrhagic gastritis,accounting for 24.3% and 15.8%,respectively.The first cause of lower gastrointestinal bleeding is colorectal cancer,accounting for34.7%,followed by hemorrhoids and colon polyps,accounting for 13.7% and 11.3%,respectively.3.Through analysis,the four common causes of gastrointestinal hemorrhage have obvious gender differences(χ2=28.93,P=0.00),and there are significant differences in the etiology composition between different age groups(χ2=83.91,P=0.00),and between different age groups The differences in the composition ratio of the etiology were statistically significant.The young group and the middle-aged group(χ2 =24.54,P=0.00),the young group and the old group(χ2=53.19,P=0.00),the middle-aged group and the old group Group(χ2=20.61,P=0.00).There was no statistically significant difference in etiology among the non-smoking,smoking,and smoking cessation groups(χ2=7.13,P=0.31).There was a difference in etiology between the drinking and non-drinking groups,which was statistically significant(χ2=9.67,P=0.022).According to whether the patients took non-steroidal anti-inflammatory drugs,antiplatelet drugs and anticoagulant drugs,they were divided into medication and non medication groups.There was no significant difference in etiology between medication and non medication groups(χ2=7.49,P=0.058).4.A longitudinal comparison of the four common causes of gastrointestinal bleeding in our hospital.Peptic ulcer and esophageal and gastric varices have always been the main causes of gastrointestinal bleeding in our hospital.The proportion of peptic ulcer increased from 31.6% in 2015 to 2019.Bleeding caused by esophageal and gastric varices slowly decreased from 41.1% in 2015 to 24.6% in 2019.The number of cases of acute hemorrhagic gastritis and colon cancer has no obvious change in five years,and the trend is relatively stable.5.Among 1319 patients with gastrointestinal bleeding,40 died,with an overall mortality rate of 3.03%,aged 23-96 years.Among them,9 had bleeding from esophageal and gastric fundus varices,with a mortality rate of 5.23%(9/172);5patients with peptic ulcer with bleeding,with a mortality rate of 1.87%(5/267);2patients with biliary bleeding,with a mortality rate of 66.67%(2/3);1 patient with gastric cancer accompanied by bleeding,1 patient with small intestinal bleeding,and22 patients did not know the cause of the bleeding.1278 patients with gastrointestinal bleeding were discharged after conservative medical treatment and endoscopic treatment.Only one patient underwent surgical treatment for bleeding from esophageal and gastric varices.926 people had different degrees of anemia,the incidence of anemia was 70.20%,and 509 of them were treated with blood transfusion.Conclusion:1.The majority of patients with gastrointestinal bleeding are men,with an average age of 61.17±19.28 years old,women are older than men,and most of them are elderly patients.The overall mortality rate is 3.03%.2.Most patients with gastrointestinal bleeding have no obvious predisposing factors,and those with obvious predisposing factors are related to drinking.3.The top three causes of upper gastrointestinal bleeding in our hospital are peptic ulcer,esophageal-gastro varices,and acute hemorrhagic gastritis.The top three causes of lower gastrointestinal bleeding are colorectal carcinoma,hemorrhoids,and colon polyps.