Document Detail

Upper gastrointestinal bleeding: predictors of outcome.
MedLine Citation:
PMID:  3490003     Owner:  NLM     Status:  MEDLINE    
We reviewed the records of 115 patients treated for upper gastrointestinal (UGI) bleeding on a general surgical and trauma service from January 1981 to June 1984. Clinical variables were analyzed with regard to three outcome criteria: mortality rate, blood transfusion requirements, and need for operation. Endoscopy was performed in all patients, usually within 24 hours of detection of bleeding. Thirty-six patients required greater than or equal to 5 U of blood, 27 patients required an operation for bleeding, and 26 patients (23%) died in the hospital. In 19 patients, death was attributed to the patient's underlying disease; in seven patients, death was due to bleeding or operation. Significant predictors of death were: age greater than or equal to 60 years old (p less than or equal to 0.02), disease in three organ systems (p less than 0.05), 5 U transfusion requirement (p less than 0.001), operation for bleeding necessary (p less than 0.03), lung/liver disease (p less than 0.03), and recent stress of major operation, trauma, or sepsis. Mortality rates were highest for bleeding varices (36%) and lowest for duodenal ulcers (7.7%) and gastric ulcers (15.8%). Endoscopy accurately determined the cause of UGI bleeding in most patients. The data suggest that the unchanging mortality rate for UGI bleeding is largely due to underlying disease or injury for which the success of current treatment is limited.
G Larson; T Schmidt; J Gott; S Bond; C A O'Connor; J D Richardson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  100     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1986 Oct 
Date Detail:
Created Date:  1986-10-30     Completed Date:  1986-10-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  765-73     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Aged, 80 and over
Blood Transfusion
Gastritis / mortality
Gastrointestinal Hemorrhage / etiology,  mortality*,  surgery
Middle Aged
Peptic Ulcer Hemorrhage / mortality

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