Risk Factors Associated with Nosocomial Upper Gastrointestinal Bleeding in Non ICU Patients Internal Medicine Department, Maharat Nakhon Ratchasima Hospital.

Abstract

     This study was retrospective unmatched case-control study was conducted aimed to identify the factors correlating with UGIB among patients in the Department of Internal Medicine at Maharat Nakhon Ratchasima Hospital. Study to investigate factors related to upper gastrointestinal bleeding in patients admitted to the non-ICU of the Department of Internal Medicine, Maharat Nakhon Ratchasima Hospital, from January 1, 2019, to December 31, 2021. Involving patients aged 18 years and older admitted to the non-ICU of Internal Medicine who had UGIB after admitted for 72 hours or more. These individuals were categorized into Case and Control groups, each comprising 190 patients. Data analysis ensued via STATA version 10.

     Results: The Case and Control groups differed significantly in terms of gender and age distribution, with 64.7% and 51.1% males in the Case and Control groups, respectively (p-value=0.009), and individuals aged 60 years and older accounting for 61.6% and 48.4% in the Case and Control groups, respectively (p-value=0.013). There was no significant difference in the length of hospital stay between the two groups. Regarding underlying diseases, significant differences were observed in the prevalence of diabetes mellitus (37.9% vs. 19.5%, p-value <0.001), hypertension (45.8% vs. 33.7%, p-value=0.021), chronic kidney disease (22.1% vs. 12.6%, p-value=0.021), and liver cirrhosis (10.0% vs. 4.2%). For medication used, the only significant difference between two groups was the use of oral anticoagulants, with 2.1% in the Case group and 9.0% in the Control group. Multivariable logistic regression analysis revealed that significant risk factors for upper gastrointestinal bleeding included the use of mechanical ventilation for more than 48 hours (Adjusted OR 2.03; 95% CI 1.18, 3.50, p-value=0.011), bloodstream infections (Adjusted OR 2.17; 95% CI 1.21, 3.89, p-value=0.009), and acute and chronic kidney injury (Adjusted OR 5.29; 95% CI 3.12, 8.95, p-value <0.001). However, other variables were not statistically significant. A history of previous upper gastrointestinal bleeding showed a relatively high association with current upper gastrointestinal bleeding, but the association was not statistically significant (Adjusted OR 9.20; 95% CI 0.95, 89.28, p-value = 0.056).