| DOI: https://doi.org/10.29090/psa.2018.03.184 | Pharm Sci Asia 2018; 45(3), 184-194 |
The treatment of non-variceal gastrointestinal bleeding: An investigation in a Vietnamese hospitalX.T. Ngo, T.T.Q. Ngo, D.T. Vo, Q.T.H. Bui*
1 Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
2 Department of Gastroenterology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
3 Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
Non-variceal upper gastrointestinal bleeding (NVUGIB) is a critical condition, which frequently leads to hospitalization or mortality. European Society of Gastrointestinal Endoscopy (ESGE) and Asia-Pacific Working Group consensus on the Management of Patients with Non-variceal Upper Gastrointestinal Bleeding (ICON-UGIB) has provided comprehensive guidelines for diagnosis and management of NVUGIB. The aims of this study were to determine to rate of appropriate indications for treatment of patients with NVUGIB and whether the use of recommended resuscitative measures and drugs contribute to the improvement of patients. A descriptive cross-sectional study was conducted using medical records of in-patients diagnosed with NVUGIB from 1st January 2016 and 30th Jun 2016 at Thong Nhat hospital, Vietnam. Patients’ clinical characteristics, endoscopic profiles, and treatments were recorded. The Glasgow Blatchford score was evaluated without endoscopic findings, whereas Forrest classification is based on endoscopic findings of an ulcer. The rational treatment of NVUGIB was evaluated based on European Society of Gastrointestinal Endoscopy (2015) and Asia-Pacific Working Group consensus on NVUGUB (2011). There were 98 patients of median age 59.9 years, and 33.7% of them had peptic ulcer disease. Most patients were male (65.3%). Appropriate indications of blood transfusion (OR 19.74, 95%CI 2.00 – 194.45, p=0.011), endoscopic hemostasis (OR 19.61, 95%CI 1.54 – 250.00, p=0.019), post-endoscopy PPI (OR 40.27, 95%CI 4.56 – 355.85, p=0.001), and acid tranexamic (OR 4.06, 95%CI 1.07 – 15.43, p=0.039) were associated with improvement of patient outcomes. Amelioration of NVUGIB patients depends on the rational indications of blood transfusion, endoscopic haemostasis, and PPIs. Optimization and personalization are essential to improve effectiveness and safety of the treatment.
Keyword:
Non-variceal upper gastrointestinal (NVUGIB), Proton pump inhibitors (PPIs), Endoscopy therapy, Blood transfusion, Tranexamic acide
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