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Advanced age, encephalopathy, cardiovascular complications, and combined antiplatelet–anticoagulant therapy independently predict in-hospital mortality in H. pylori–negative, non-variceal upper gastrointestinal bleeding.
As the epidemiology of upper gastrointestinal bleeding (UGIB) continues to evolve, Helicobacter pylori (H. pylori)–negative non-variceal bleeding increasingly represents a clinically complex population in which aging, comorbid illnesses, and antithrombotic therapy shape patient outcomes beyond the bleeding event itself. Recognizing this changing disease profile, the investigators evaluated the underlying causes, clinical characteristics, and independent predictors of in-hospital mortality in affected patients.
They reviewed the medical records of adults hospitalized with endoscopically confirmed H. pylori–negative non-variceal UGIB at a tertiary referral center. Demographic characteristics, comorbidities, medication exposure, and endoscopic findings were systematically evaluated, while multivariable regression analysis identified independent predictors of in-hospital mortality.
Among 285 hospitalized patients with H.pylori–negative non-variceal UGIB, multivariable analysis distinguished the clinical characteristics that independently influenced in-hospital mortality.
Key analysis:
The era of H. pylori–driven UGIB is giving way to a more complex clinical landscape shaped by aging, multimorbidity, and widespread antithrombotic use. This study highlights the requirement to look beyond the bleeding lesion itself and focus on the patient's overall clinical profile. Incorporating these mortality predictors into early risk assessment may help clinicians prioritize intensive monitoring and timely intervention.
Clinical and Experimental Gastroenterology
Predictors of In-Hospital Mortality in Helicobacter pylori–Negative, Non-Variceal Upper Gastrointestinal Bleeding: A Retrospective Cohort Study
Giselle María Padilla Gutiérrez et al.
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