RISK FACTORS FOR THE NEGATIVE COURSE OF GASTRODUODENAL GASTROINTESTINAL BLEEDING IN OBESE PATIENTS

Andrian Reiti; Oleksandr Shcherbina

doi:10.23856/6629

Andrian Reiti P. L. Shupyk National Healthcare University https://orcid.org/0000-0002-1807-2470
Oleksandr Shcherbina Communal Non-Commercial Enterprise “Kyiv City Clinical Hospital № 7” https://orcid.org/0009-0000-9991-7588

Keywords: peptic ulcer disease, obesity, gastrointestinal bleeding

Abstract

Obesity affects 18% of adults in Ukraine, which is one of the highest rates on the European continent. Treating gastrointestinal ulcer bleeding in obese patients is challenging due to 75% of them are taking at list one ulcerogenic or blood-thinning medications, and 25% use three or more because comorbidities. The problem of treating and predicting the outcomes of ulcerative bleeding in such patients is insufficiently studied. This study aimed to assess treatment outcomes for acute ulcerative bleeding in sever obese patients, evaluate the effects of age and medication use, and compare these with outcomes in normal-weight patients. To achieve this goal, a retrospective analysis included 82 sever obese and 282 normal- weight patients, focusing on early recurrences and mortality. The study found that in obese patients under the age of 40, the mortality rate was more than three times higher (7.3%) compared to patients of normal weight (2.1%) (p – 0.0296). However, after the age of 40, no statistically significant difference in mortality was confirmed between the study groups (8.5% and 4.9%, respectively, p- 0.2864). Additionally, no increased risk of early rebleeding was observed in patients using non steroid anti inflammatory drugs or and/or drugs, affecting the rheological or coagulation properties of the blood (12.2% vs. 5%, p = 0.2527). Thus, based on the obtained data, in Ukraine young age and obesity are risk factors for poor prognosis in treating gastrointestinal bleeding due to limited use of medications for comorbidities and resulting homeostasis issues. Despite this, they do not increase early rebleeding. The study suggests revising treatment strategies for young obese patients.

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