Proposed risk stratification in upper gastrointestinal haemorrhage: Is hospitalisation essential?

Courtney, Aisling E.; Mitchell, R. M.; Rocke, L G; Johnston, Brian T.

doi:10.1136/emj.2003.012328

Cited by 10 publications

(4 citation statements)

References 7 publications

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“…and international guidelines. [ 3 4 ] The guidelines and care pathway were disseminated throughout the hospital to house officers, residents, attending physicians, and nursing staff. Therapy was given according to a standard protocol.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcome of acute upper gastrointestinal hemorrhage among patients admitted to a government hospital in Egypt

Gado¹,

Ebeid²,

Abdelmohsen

et al. 2012

Saudi J Gastroenterol

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Background/Aim:Acute upper gastrointestinal hemorrhage (AUGIH) is a life-threatening emergency that results in high morbidity and mortality. The mortality rate varies between 4% and 14%. The aim of the study was to determine the clinical outcome of AUGIH among patients admitted to a government hospital in Egypt.Patients and Methods:This was a cross-sectional hospital-based study performed in 1000 patients presenting with AUGIH over a 7-year period between January 2004 and January 2011.Results:One thousand patients were analyzed. Fifty-four percent were male. Mean age was 52 ± 17 years. Eighty-eight percent were emergency admissions and 12% were inpatients at the time of bleeding. At presentation 68% had major comorbidity and 50% had liver disease. Seven hundred and twenty-four patients (72%) underwent endoscopy. Bleeding varices accounted for 31% of AUGIH and peptic ulcer 28%. Two hundred and thirty-two patients had endoscopically diagnosed bleeding varices or peptic ulcer with a visible vessel or active bleeding. These received endoscopic therapy. Initial hemostasis was achieved in 207 (89%). Thirteen patients (6%) had therapy at a subsequent endoscopy for further bleeding. Surgery was performed on 9 patients (0.9%) with AUGIH. Complications were reported in 70 patients (7%) mainly liver failure (4%). Six hundred and eighty-four patients (68%) were discharged improved, 162 (16%) left hospital without a diagnosis and 4 (0.4%) were referred to another facility. The overall mortality was 15%. Mortality was 24% in patients ≥60 years, 37% among inpatients, and 21% in those who had a major comorbidity. Mortality was 22% in patients who had liver disease and 9% in variceal bleeding.Conclusion:The most common cause of AUGIH was variceal in origin. Endoscopic therapy was successful in most cases. Mortality after AUGIH was particularly high among elderly patients, inpatients, and patients who had a major comorbidity, liver disease, and variceal bleeding.

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Section: Methodsmentioning

confidence: 99%

Clinical outcome of acute upper gastrointestinal hemorrhage among patients admitted to a government hospital in Egypt

Gado¹,

Ebeid²,

Abdelmohsen

et al. 2012

Saudi J Gastroenterol

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“…Recently there has been some evidence to suggest that not all patients with upper GI bleeding need to be admitted, as some can be managed with an outpatient review and endoscopy. 52 This practice only applies to those at a low risk of significant bleeding and so those aged over 60 years rarely fit into this category.…”

Section: Upper Gi Tract Bleedingmentioning

confidence: 99%

Upper gastrointestinal disease in the elderly patient

Singhal

Bowling

2005

Rev. Clin. Gerontol.

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“…18,19 Although small, we assumed a rate of death following a discharge despite the patient bleeding of 0.1%. 7,10,20 The probability of re-bleeding after initial hemostasis was 12% and of these patients, there was a 30.6% probability of re-bleeding. 8 Patients who re-bled for a second time will have surgery to perform a duodenal or gastric suture and there is a risk of mortality from the procedure of 4%.…”

Section: Model Parameters/input Parametersmentioning

confidence: 99%

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

Meltzer¹,

Ward²,

Gralnek³

et al. 2013

Annals of Emergency Medicine

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Proposed risk stratification in upper gastrointestinal haemorrhage: Is hospitalisation essential?

Cited by 10 publications

References 7 publications

Clinical outcome of acute upper gastrointestinal hemorrhage among patients admitted to a government hospital in Egypt

Clinical outcome of acute upper gastrointestinal hemorrhage among patients admitted to a government hospital in Egypt

Upper gastrointestinal disease in the elderly patient

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

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