title: The role of an open-access bleeding unit in the management of colonic haemorrhage. A 2-year prospective study.
abstract: BACKGROUND
  Major colonic haemorrhage poses difficult diagnostic and therapeutic problems and, in contrast to upper gastrointestinal bleeding, has no generally accepted plan of management.
  
  
  METHODS
  We report community-based prospective data accumulated over 2 years (1991-93) on 1602 patients referred to an open-access bleeding unit with suspected gastrointestinal haemorrhage.
  
  
  RESULTS
  Of 278 (17%) admissions with suspected lower GI haemorrhage, 252 were confirmed. Forty-eight per cent were defined as "significant' bleeds, with a decrease in haemoglobin and cardiovascular compromise. Of 102 significant bleeds in subjects more than 60 years old, 29% rebled, and 12.6% required emergency surgery. Diverticular disease (24%) was the commonest diagnosis, with tumours, infective colitis, and inflammatory colitis each at 10%. The overall 30-day mortality for colonic bleeding was 5.1% (13 of 252), with only 1 death occurring in the group less than 60 years old.
  
  
  CONCLUSIONS
  This study provides a unique database for the natural history of colonic bleeding and its management within the setting of a specialized bleeding unit.
authors.affiliation: Gastrointestinal Unit, Aberdeen Royal Infirmary, Forresterhill, Scotland.
authors.forename: P N
authors.initials: PN
authors.lastname: Bramley
authors.forename: J W
authors.initials: JW
authors.lastname: Masson
authors.forename: G
authors.initials: G
authors.lastname: McKnight
authors.forename: K
authors.initials: K
authors.lastname: Herd
authors.forename: A
authors.initials: A
authors.lastname: Fraser
authors.forename: K
authors.initials: K
authors.lastname: Park
authors.forename: P W
authors.initials: PW
authors.lastname: Brunt
authors.forename: A
authors.initials: A
authors.lastname: McKinlay
authors.forename: T S
authors.initials: TS
authors.lastname: Sinclair
authors.forename: N A
authors.initials: NA
authors.lastname: Mowat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D014218:Triage