NON-VARICOSE BLEEDING FROM THE UPPER GASTROINTESTINAL TRACT

Abstract

Introduction. Non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the most critical issues in emergency 
surgery. This pathology is characterized by a high prevalence and significant mortality rates, especially among elderly 
patients and individuals with comorbid conditions. 
Aim. To study the treatment outcomes of patients with non-variceal upper gastrointestinal bleeding. 
Materials and methods. A retrospective study was conducted among n = 667 patients who received inpatient treatment at the 
surgical department of the City Emergency Hospital in Almaty from January 1, 2019, to December 31, 2023. Mean values (M ± m) 
and differences between arithmetic means were assessed using Student’s t-test. The relationship between clinical parameters and 
outcomes was evaluated using the chi-square (χ²) test. Risk factors for adverse outcomes (mortality, rebleeding, need for surgical 
treatment) were analyzed using logistic regression. The impact of factors was assessed by calculating the odds ratio (OR) with a 
95% confidence interval (95% CI). A p-value < 0.05 was considered statistically significant. 
Results. The primary causes of bleeding were acute ulcers (60.4%), Mallory-Weiss syndrome (20.4%), chronic ulcers 
(13.2%), and bleeding of unknown etiology (6.0%). According to the Forrest classification, the most common form was IIB 
(54.5%). The overall rebleeding rate was 6.9%, while the total mortality rate was 3.6%. Mortality rates by etiology were as 
follows: acute ulcers – 2.7%, chronic ulcers – 5.6%, Mallory-Weiss syndrome – 0.7%, and bleeding of unknown etiology – 
17.5%. The average surgical intervention rate during the study period was 2.8%. 
Conclusions. Thus, non-variceal upper gastrointestinal bleeding remains a pressing issue in gastroenterology and 
surgery, requiring a comprehensive approach to diagnosis and treatment. The study confirmed the high prevalence of peptic 
ulcer disease, Mallory-Weiss syndrome, and erosive lesions as leading causes of bleeding. The main risk factors for 
NVUGIB include the use of anticoagulants, nonsteroidal anti-inflammatory drugs, and cardiovascular diseases, highlighting 
the necessity of careful medication management in patients at high risk of bleeding.