Characteristics and outcomes of upper gastrointestinal hemorrhage in a tertiary referral hospital.
OBJECTIVE
Upper gastrointestinal hemorrhage remains a problem in spite of improved diagnosis and management. There is sparse knowledge of recent epidemiology and outcomes. We wanted to evaluate the characteristics and outcomes of patients with upper gastrointestinal hemorrhage over a 4-year period in a tertiary referral hospital.


METHODS
We prospectively collected data on patients admitted with upper gastrointestinal hemorrhage to John Hunter Hospital between August 2004 and December 2008. Variables of interest included age, gender, co-morbidities, and time to endoscopy. Main outcomes included etiology, treatment, and survival. Variceal and non-variceal bleeds were analyzed separately.


RESULTS
There were 792 admissions from 734 unique patients (61% male) with a mean age of 66 years. The most frequent causes of non-variceal bleeds (88%) included ulcers 265 (33%); Mallory Weiss tear 91 (11%); esophagitis 60 (8%), and malignancy 29 (4%). Most patients had one or more co-morbidity (74%). Transfusion was not employed in 41%. Overall mortality was 4.0% (5.4% in the variceal and 3.9% in the non-variceal group). Only 1.9% of patients had surgery.


CONCLUSIONS
Patients presenting with upper gastrointestinal hemorrhage are overall elderly with significant co-morbidities. Our overall mortality and surgery rates are lower than in previously published international data.
Halland
Magnus
M
Department of Gastroenterology, John Hunter Hospital, Locked Bag 1, New Lambton, Newcastle, NSW 2305, Australia. magnushalland@ausdoctors.net
Young
Melissa
M
Fitzgerald
Michael N
MN
Inder
Kerry
K
Duggan
John M
JM
Duggan
Anne
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000453:epidemiology; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
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