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Prognostic factors in upper gastrointestinal bleeding

Digestive Diseases and Sciences volume 39, pages 706–712 (1994)Cite this article

Abstract

In this study we examined factors of possible prognostic value about outcome in a consecutive series of 2217 patients with hematemesis and melena. Death occurred in 189 (8.5%) patients, and 243 (11%) patients experienced rebleeding. Death was significantly associated with rebleeding, age over 60 years, and the finding of blood in the stomach at endoscopy. Rebleeding was significantly associated with melena, identification of a gastric or duodenal ulcer, endoscopic stigmata of hemorrhage such as blood, clot, and active bleeding, and the finding of shock at admission. However, female gender, previous history of ulceration, or indigestion of ulcerogenic drugs, especially nonsteroidal antiinflammatory drugs, were poor predictors of either death or rebleeding. We conclude that the identification of patients at a high risk could contribute to improved management of patients with gastrointestinal bleeding, including early therapeutic intervention.

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Affiliations

  1. From the Departments of Therapeutics and Epidemiology & Community Medicine, University Hospital, Nottingham, UK

    Bettina Katschinski MD, Richard Logan FRCPE, Jackie Davies BSC, Gail Faulkner RN, Jim Pearson MSC & Michael Langman FRCP

Authors
  1. Bettina Katschinski MD
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  2. Richard Logan FRCPE
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  3. Jackie Davies BSC
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  4. Gail Faulkner RN
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  5. Jim Pearson MSC
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  6. Michael Langman FRCP
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Additional information

Bettina Katschinski was supported by Deutsche Forschungs-gemeinschaft grant Ka 665/1-1.

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Katschinski, B., Logan, R., Davies, J. et al. Prognostic factors in upper gastrointestinal bleeding. Digest Dis Sci 39, 706–712 (1994). https://doi.org/10.1007/BF02087411

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  • DOI: https://doi.org/10.1007/BF02087411

Key words

  • prognostic factors
  • gastrointestinal bleeding
  • nonsteroidal antiinflammatory drugs
  • endoscopic stigmata
  • hemorrhage