Effects of Seasonal Variation on Upper Gastrointestinal System Bleeding in Emergency Department

Objective: Multiple factors are known to be associated with a high risk of morbidity and mortality in Upper Gastrointestinal Bleeding (UGB). In addition to these risk factors, it has been suggested that seasonal variations can influence UGB. In this study, it is investigated whether there is a relation between seasonal variation and the incidence of UGB, Glasgow-Blatchford risk score and clinical and laboratory parameters. Methods: We retrospectively reviewed the records of the patients who were diagnosed and hospitalized with UGB. Age, gender, admission date, laboratory parameters, vital signs and Glasgow-Blatchford risk score at admission, intensive care unit admission, length of stay, erythrocyte suspension transfusion requirement and outcome were all documented. Patients who were referred to another hospital despite having diagnosed UGB, patients who were found to have been misdiagnosed while follow-up and patients under 18 years old were excluded. The 12 months of the year were divided into four seasons as winter, spring, summer and autumn. Results: We included 271 patients, of whom 163 were males and 108 were females. While 205 patients were followed in intensive care unit, 66 were followed in the ward. Erythrocyte suspension transfusion had been applied to 187 patients and 35 patients had died. High blood urea nitrogen, Glasgow-Blatchford risk score and heart rate, and low systolic and diastolic blood pressure was found statistically associated with mortality. The number of patients with UGB increases in spring with a raise especially in May and bottoms out in autumn. There was no statistically significant difference at clinical and laboratory findings between seasons. Conclusion: We observed that UGB incidence increases in spring and emergency physicians need to be more prepared in that season. However, none of the clinical or laboratory variables has been found statistically associated with seasonal factors