Mortality in high-risk patients with bleeding Mallory-Weiss syndrome is similar to that of peptic ulcer bleeding. Results of a prospective database study.
OBJECTIVE
The aim of this study was to identify the predictive factors influencing mortality in patients with bleeding Mallory-Weiss syndrome in comparison with peptic ulcer bleeding.


METHODS
Between January 2005 and December 2009, 281 patients with endoscopically confirmed Mallory-Weiss syndrome and 1530 patients with peptic ulcer bleeding were consecutively evaluated. The 30-day mortality and clinical outcome were related to the patients' demographic data, endoscopic, and clinical characteristics.


RESULTS
The one-year cumulative incidence for bleeding Mallory-Weiss syndrome was 7.3 cases/100,000 people and for peptic ulcer bleeding 40.4 cases/100,000 people. The age-standardized incidence for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding remained unchanged during the observational five-year period. The majority of patients with bleeding Mallory-Weiss syndrome were male patients with significant overall comorbidities (ASA class 3-4). Overall 30-day mortality rate was 5.3% for patients with bleeding Mallory-Weiss syndrome and 4.6% for patients with peptic ulcer bleeding (p = 0.578). In both patients with bleeding Mallory-Weiss syndrome and peptic ulcer bleeding, mortality was significantly higher in patients over 65 years of age and those with significant overall comorbidities (ASA class 3-4).


CONCLUSIONS
The incidence of bleeding Mallory-Weiss syndrome and peptic ulcer bleeding has not changed over a five-year observational period. The overall 30-day mortality was almost equal for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding and was positively correlated to older age and underlying comorbid illnesses.
Department of Internal Medicine, Division of Gastroenterology, "Sestre milosrdnice" University Hospital Center, Medical and Dental Faculty, University of Zagreb , Zagreb 10000, Vinogradska 29 , Croatia.
Neven
N
Ljubičić
Ivan
I
Budimir
Tajana
T
Pavić
Alen
A
Bišćanin
Zeljko
Z
Puljiz
Andre
A
Bratanić
Branko
B
Troskot
Dražen
D
Zekanović
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D005260:Female; D005773:Gastroscopy; D006801:Humans; D015994:Incidence; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000401:mortality*; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires