OBJECTIVE

Prognostic assessment of the risk of recurrence of gastroduodenal bleeding.

MATERIAL AND METHODS

To achieve this goal, we conducted a retrospective analysis of 251 clinical cases of acute gastroduodenal bleeding (AGDB) in patients who were hospitalized at the Republican Clinical Hospital of Emergency Medical Care in Makhachkala from 2017 to 2023. In total, there were 154 (61.35%) male patients and 97 (38.63%) female patients. The age of the patients ranged from 38 to 79 years (mean 61.4±11.3 years), more than 39% of respondents were elderly. Predicting the risk of relapse allowed us to determine the feasibility and timeliness of a set of preventive measures using endovascular hemostasis.

RESULTS

All patients underwent endoscopic hemostasis upon admission. Of the 251 patients, 28 (11.15%) underwent endoscopic hemostasis under the action of adrenaline, while 223 (88.84%) received combined hemostasis. Rebleeding occurred in 38 (15.14%) patients. Primary endoscopic hemostasis was effective in 84.86% of cases, but in 15.14% of cases, bleeding could not be stopped endoscopically, which led to recurrence of bleeding and required an alternative method of treatment. Combined treatment of OGDC led to effective endohemostasis in 84.86% of cases, recurrence in 5.14% of cases and death in 3.58%. Patients with endovascular hemostasis were treated in 38 (15.14%) cases, the mortality rate was 2.63%.

CONCLUSIONS

Clinically significant parameters associated with recurrent bleeding were shock on admission, smoking duration, amount of blood transfused, ulcer size, and endoscopic stigmata of high risk for recurrent bleeding. The results show that the endovascular method can provide effective hemostasis in 96.36% of patients whose bleeding from gastroduodenal ulcer is not amenable to endoscopic control.