title: Impact of ethnicity in upper gastrointestinal hemorrhage.
abstract: OBJECTIVE
  To examine ethnicity's role in the etiology and outcome of upper gastrointestinal hemorrhage (UGIH).
  
  
  BACKGROUND
  UGIH is a serious condition with considerable associated morbidity and mortality.
  
  
  METHODS
  We analyzed 2196 patients admitted with acute UGIH between January 2006 and February 2012. Complete clinical data were gathered prospectively and entered into our GI Bleed Registry, which captures demographic and clinical variables. Results were analyzed using the χ² analyses and the analysis of variance techniques with Tukey multiple comparisons.
  
  
  RESULTS
  Among 2196 patients, 620 (28%) were black, 625 (29%) white, 881 (40%) Hispanic, and 70 (3%) were members of other ethnicities. Gastroduodenal ulcers (25%), esophageal varices (25%), and esophagitis (12%) were the most frequently identified causes of UGIH. Blacks experienced a high rate of gastroduodenal ulcers (199/620), whereas Hispanics most commonly had esophageal varices. In all ethnicities, the most common cause of bleeding in patients younger than 35 or older than 65 years was gastroduodenal ulcer disease. However, among patients aged 35 to 64 years, there were differences in the etiology of UGIH. Blacks aged 50 to 64 years frequently experienced gastroduodenal ulcers, whereas Hispanics aged 35 to 49 years typically had esophageal varices. Rebleeding rates were significantly lower in whites (5.8%) than in Hispanics (9.9%) or blacks (8.7%) (P=0.02).
  
  
  CONCLUSIONS
  By examining a diverse population, we conclude that UGIH may follow trends. Hispanics were likely to have esophageal varices and higher rebleeding rates, whereas blacks were likely to have ulcers and the highest mortality. Whites were equally likely to have ulcers or varices, but a lower rate of rebleeding.
authors.affiliation: *Division of Digestive and Liver Diseases †Department of Clinical Sciences, University of Texas Southwestern Medical Center and the Parkland Health and Hospital System, Dallas, TX.
authors.forename: Casey S
authors.initials: CS
authors.lastname: Wollenman
authors.forename: Rebecca
authors.initials: R
authors.lastname: Chason
authors.forename: Joan S
authors.initials: JS
authors.lastname: Reisch
authors.forename: Don C
authors.initials: DC
authors.lastname: Rockey
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D004941:Esophagitis / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000208:ethnology / Q000209:etiology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D012008:Recurrence; D012042:Registries; D044465:White People