title: Initial Assessment and Resuscitation in Nonvariceal Upper Gastrointestinal Bleeding.
abstract: Acute nonvariceal upper gastrointestinal bleeding remains an important cause of hospital admission with an associated mortality of 2-14%. Initial patient evaluation includes rapid hemodynamic assessment, large-bore intravenous catheter insertion and volume resuscitation. A hemoglobin transfusion threshold of 7 g/dL is recommended, and packed red blood cell transfusion may be necessary to restore intravascular volume and improve tissue perfusion. Patients should be risk stratified into low- and high-risk categories, using validated prognostic scoring systems such as the Glasgow-Blatchford, AIMS65 or Rockall scores. Effective early management of acute, nonvariceal upper gastrointestinal hemorrhage is critical for improving patient outcomes.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
authors.forename: Tracey G
authors.initials: TG
authors.lastname: Simon
authors.affiliation: Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Travis
authors.affiliation: Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address: jsaltzman@partners.org.
authors.forename: John R
authors.initials: JR
authors.lastname: Saltzman
mesh_terms: D000208:Acute Disease; D001803:Blood Transfusion / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000628:therapy*; D014943:Global Health; D006801:Humans; D015994:Incidence; D011379:Prognosis; D012151:Resuscitation / Q000379:methods*; D018570:Risk Assessment
keywords: AIMS65; Gastrointestinal bleeding; Glasgow-Blatchford score; Nonvariceal hemorrhage; Risk stratification