Assessment of Endoscopic findings in patients presenting with Non-Variceal Upper Gastrointestinal Bleeding at a tertiary centre in Nepal

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a frequently found clinical emergency condition which can have serious outcome. Associated risk factors, clinical picture, and final outcomes differ by locality and available healthcare facilities. This study targets to reflect the demographics, associated risk factors, underlying comorbidities, and outcomes of patients admitted with upper gastrointestinal bleeding at a tertiary care centre in Kathmandu, Nepal. Methods: This is a retrospective observational descriptive study done at Grande International Hospital, Nepal. Medical record charts of patients aged 18 years or more, admitted with upper gastrointestinal bleeding from July 2024 to June 2025 were included. Data which included demographic profile, clinical picture, associated risk factors, underlying comorbidities, laboratory values, upper gastrointestinal endoscopic findings, performed interventions and final outcomes were assembled. Data analysis was done using Microsoft Excel. Patients who were handled in outpatient department or admitted for other medical conditions who de veloped upper gastrointestinal bleeding afterwards were not included in the study. Results: In this study, 104 patients were included. The male to female ratio found is 2.05:1 with a mean age of 59.38 years at presentation. Melena is found to be the most common clinical finding (68.3%) in this study. The most frequent risk factors are alcohol use (42.3%) and NSAID (Non-Steroidal Anti-Inflammatory Drug) consumption (32.6%). Hypertension (17.3%) and coronary artery disease (15.3%) are the leading comorbidities. The mean hemoglobin level is 7.22 g/dL. Endoscopy was performed in 21.15% of patients within 24 hours of admission, with gastric ulcer (Forrest 1b) (31.8%) being the most common finding. The average blood transfusion done was 1.04 units of packed RBCs per patient. Most patients (92%) were discharged after clinical improvement, while 2.9% expired. The cause of death in all who expired was due to associated coronary artery disease. Conclusion: UGIB remains a significant health burden with alcohol and NSAID use as key risk factors. Early identification and supportive care remain essential for favorable outcomes in tertiary care settings.