To Compare the Outcomes of Emergency Procedures Versus Elective Procedures for the Treatment of Upper GI Hemorrhage Resulting from Portal Hypertension

  • Abdul Ghani Resident Emergency Medicine, Ziauddin University Hospital Karachi
  • Areej Zehra Alam Resident Emergency Medicine, Ziauddin University Hospital Karachi
  • Shua Nasir Registrar Emergency Medicine Ziauddin University Hospital Karachi
  • Muhbat Ali Resident Emergency Medicine, Ziauddin University Hospital Karachi
  • Lal Shehbaz Registrar Emergency Medicine Ziauddin University Hospital Karachi
  • Zain Ali House Officer, Civil Hospital Karachi
Keywords: Upper gastrointestinal hemorrhage, elective surgery, emergency surgery, esophageal varices

Abstract

Objective: The aim of this study is to compare the outcomes of emergency procedures versus elective procedures when it comes to surgical procedures performed for the treatment of upper GI hemorrhage resulting from portal hypertension. Methods: The type of study is a retrospective review of n= 221 patients who came to us with the complaint of upper GI bleeding as a result of portal hypertension and treated with a surgical procedure (either elective or emergency procedure), the study is conducted with data from April 2011 to December 2015 from a tertiary care center in Karachi, Pakistan. Various variables such as patient’s age, gender, complete history, length of stay in the hospital, postoperative complications such as infection, re-bleeding etc. were noted along with the mortality rate of the patients. Statistical analysis was done via SPSS version 23. Results: The patients population consisted of n= 221 patients of which n= 140 (63.34%) were male and n=81 (36.65%) were female having a mean age of 48.1 ± 12.5 years. N= 154 patients belonged to Group A which is the patients who underwent elective surgery, while n= 67 patients belonged to group B the emergency surgery group. The patients, age, gender, history and child pugh classification did not show any significant difference among the two groups. N= 11 (16.41%) patients had complications in the emergency surgery group, and n= 18 (11.68%) patients suffered from complications in the elective surgery group having a p value of >0.05. Among the two groups under study, n= 6 (3.89%) patients died in the elective surgery group and n= 8 (11.94%) patients died in the emergency surgery group. Conclusion: According to the results of our study patients belonging to Grade A and B of the child pugh classification can be treated as an emergency surgical procedure as compared to the elective procedure as both have similar rates of complications and mortality, but for patients belonging to Grade C care should be taken as there is a high rate of complication and mortality with emergency procedure.

Published
2017-01-02
How to Cite
Ghani, A., Alam, A., Nasir, S., Ali, M., Shehbaz, L., & Ali, Z. (2017). To Compare the Outcomes of Emergency Procedures Versus Elective Procedures for the Treatment of Upper GI Hemorrhage Resulting from Portal Hypertension. Annals of Punjab Medical College (APMC), 11(1), 15-19. https://doi.org/10.29054/apmc/2017.238