title: Characteristics and outcomes of upper gastrointestinal hemorrhage in a tertiary referral hospital.
abstract: 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.
authors.affiliation: Department of Gastroenterology, John Hunter Hospital, Locked Bag 1, New Lambton, Newcastle, NSW 2305, Australia. magnushalland@ausdoctors.net
authors.forename: Magnus
authors.initials: M
authors.lastname: Halland
authors.forename: Melissa
authors.initials: M
authors.lastname: Young
authors.forename: Michael N
authors.initials: MN
authors.lastname: Fitzgerald
authors.forename: Kerry
authors.initials: K
authors.lastname: Inder
authors.forename: John M
authors.initials: JM
authors.lastname: Duggan
authors.forename: Anne
authors.initials: A
authors.lastname: Duggan
mesh_terms: 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
references.citation: Dig Liver Dis. 2006 Dec;38(12):899-904
references.pmid: 17005458
references.citation: BMJ. 1997 Aug 30;315(7107):510-4
references.pmid: 9329304
references.citation: Clin Gastroenterol Hepatol. 2009 Jan;7(1):33-47; quiz 1-2
references.pmid: 18986845
references.citation: Am J Gastroenterol. 2008 Dec;103(12):3011-8
references.pmid: 19086953
references.citation: Br J Surg. 1986 Oct;73(10):783-5
references.pmid: 3533203
references.citation: Gut. 1985 May;26(5):481-4
references.pmid: 3873382
references.citation: J Gastroenterol Hepatol. 2009 Oct;24(10):1648-54
references.pmid: 19798783
references.citation: Gut. 1969 Jun;10(6):443-50
references.pmid: 5786140
references.citation: Curr Probl Surg. 1991 Apr;28(4):265-330
references.pmid: 2009749
references.citation: Gut. 1997 Nov;41(5):606-11
references.pmid: 9414965
references.citation: Gut. 1996 Mar;38(3):316-21
references.pmid: 8675081
references.citation: Aliment Pharmacol Ther. 1995;9 Suppl 2:45-51
references.pmid: 8547528
references.citation: N Engl J Med. 1994 Oct 27;331(17):1105-9
references.pmid: 7935634
references.citation: Aliment Pharmacol Ther. 2001 Aug;15(8):1109-13
references.pmid: 11472313
references.citation: Eur J Gastroenterol Hepatol. 2005 Jun;17(6):641-7
references.pmid: 15879726
references.citation: Aliment Pharmacol Ther. 2009 Aug 15;30(4):392-8
references.pmid: 19508403
references.citation: J Gastroenterol Hepatol. 2007 Jul;22(7):1009-13
references.pmid: 17608846
references.citation: Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005415
references.pmid: 17054257
references.citation: Med J Aust. 1986 Mar 3;144(5):247-50
references.pmid: 3587095
references.citation: Gastrointest Endosc. 2008 Jun;67(7):1064-6
references.pmid: 18513549
references.citation: J Clin Gastroenterol. 2008 Feb;42(2):128-33
references.pmid: 18209579
references.citation: Br J Clin Pharmacol. 2002 Feb;53(2):183-8
references.pmid: 11851642
references.citation: Emerg Med Clin North Am. 2003 Nov;21(4):1017-56
references.pmid: 14708817