Bleeding time and concentrations of von Willebrand factor in patients with acute upper gastrointestinal bleeding.
OBJECTIVE
To evaluate the prevalence of impaired primary haemostasis in patients with acute upper gastrointestinal bleeding.


METHODS
Prospective open study.


METHODS
County hospital, Sweden.


METHODS
160 consecutive patients admitted with haematemesis or melaena, or both.


METHODS
Diagnosis verified on admission by endoscopy. Consumption of non-steroidal anti-inflammatory drugs (NSAID), transfusion requirements, presence of chronic liver disease, and age were recorded.


METHODS
Skin bleeding time was measured on admission with a modified Ivy method using the Simplate II bleeding time device; von Willebrand factor and routine haematological tests were analysed.


RESULTS
In 31 of the patients (19%) the skin bleeding time was prolonged (over 10 minutes), and these patients also had a significantly lower packed cell volume on admission. In all patients the concentration of von Willebrand factor was increased which might explain why there was no significant difference in bleeding time between those who did and those who did not take NSAIDs.


CONCLUSIONS
We recommend measurement of bleeding time in patients who present with haematemesis or melaena, or both, to detect those with impaired primary haemostasis.
Department of Surgery, County Hospital, Sundsvall, Sweden.
A E
AE
Henriksson
T K
TK
Nilsson
D
D
Bergavist
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001760:Bleeding Time; D001803:Blood Transfusion; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood* / Q000209:etiology / Q000628:therapy; D006454:Hemoglobins / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D011446:Prospective Studies; D014841:von Willebrand Factor / Q000032:analysis*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006454:Hemoglobins; D014841:von Willebrand Factor