title: Effect of different operation policies on mortality from bleeding peptic ulcer.
abstract: The outcome in bleeding gastric and duodenal ulcer has been compared in two hospitals in Nottingham which take their patients randomly from a common source according to a fixed daily admission rota. Bleeding seemed equally severe in the two groups but 66 (32%) of 206 patients were operated upon at hospital A compared with 44 (46%) of 96 at hospital B (P=0.03), where operations also tended to be done earlier. Postoperative mortality-rates were virtually identical at the two hospitals, but at hospital B the overall death-rate from bleeding ulcer was higher, partly because of its higher operation-rate. The value of an aggressive surgical policy in bleeding peptic ulcer is questionable.
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D004381:Duodenal Ulcer / Q000150:complications*; D004630:Emergencies; D004739:England; D005069:Evaluation Studies as Topic; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011706:Pyloric Antrum / Q000601:surgery; D013276:Stomach Ulcer / Q000150:complications*; D013997:Time Factors; D014628:Vagotomy