Ali Masab, Naveed Haris, Ahmad Muhammad Husnain, Sheikh Ateeq Ur Rehman, Hussain Umer, Javeriya Sana, Chaudhary Kanchan, Hussain Hafiz Amjad, Naeem Sarmad
Department of Medicine, Punjab Medical College, Faisalabad, Pakistan.
Department of Medicine, Tentishev Satkynbai Memorial Asian Medical Institute, Gagarina, Kant, Kyrgyzstan.
Ann Med Surg (Lond). 2025 Apr 22;87(6):3157-3161. doi: 10.1097/MS9.0000000000003305. eCollection 2025 Jun.
This cross-sectional study investigates the prevalence and clinical outcomes of upper gastrointestinal bleeding (UGIB) among patients at a tertiary care center. It focuses on esophageal varices and their association with hepatitis C and B infections.
A total of 383 patients aged 18 and above who presented with UGIB were included. Data were collected from the hospital's endoscopy department and analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and R package. Key variables included age, gender, endoscopic findings, and the presence of esophageal varices. Fisher's exact test was used to evaluate the association between hepatitis infections and variceal bleeding. The statistical significance cut-off was <0.05.
The mean age of the 383 patients was 56 ± 11 years, with a male predominance (55.4%). Esophageal varices were the most common finding (78.3%) and were strongly associated with hepatitis C ( < 0.001), with 70.7% of hepatitis C patients presenting with varices. Hepatitis B had a much weaker association, with only 1.7% of patients with varices also testing positive for hepatitis B. Acid peptic disease, present in 11% of cases, was more common in females. The statistical analysis confirmed a significant relationship between hepatitis C and esophageal varices. The study highlights the need for routine variceal screening and hepatitis C management in high-risk populations.
Esophageal varices are the leading cause of UGIB in this population, particularly in patients with chronic hepatitis C. The findings underscore the importance of early intervention and management of hepatitis C to reduce the incidence and mortality associated with variceal bleeding in chronic liver disease patients.
本横断面研究调查了一家三级医疗中心患者中上消化道出血(UGIB)的患病率及临床结局。重点关注食管静脉曲张及其与丙型和乙型肝炎感染的关联。
纳入了383例年龄在18岁及以上的UGIB患者。数据从医院内镜科收集,并使用社会科学统计软件包(SPSS)25版和R软件包进行分析。关键变量包括年龄、性别、内镜检查结果以及食管静脉曲张的存在情况。采用Fisher精确检验评估肝炎感染与静脉曲张出血之间的关联。统计学显著性临界值为<0.05。
383例患者的平均年龄为56±11岁,男性占主导(55.4%)。食管静脉曲张是最常见的发现(78.3%),且与丙型肝炎密切相关(<0.001),70.7%的丙型肝炎患者存在静脉曲张。乙型肝炎的关联则弱得多,只有1.7%的静脉曲张患者乙型肝炎检测也呈阳性。11%的病例存在酸相关性疾病,在女性中更常见。统计分析证实丙型肝炎与食管静脉曲张之间存在显著关系。该研究强调了在高危人群中进行常规静脉曲张筛查和丙型肝炎管理的必要性。
食管静脉曲张是该人群UGIB的主要原因,尤其是在慢性丙型肝炎患者中。研究结果强调了早期干预和管理丙型肝炎对于降低慢性肝病患者静脉曲张出血相关发病率和死亡率的重要性。