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. 1989 Dec;65(770):913–917. doi: 10.1136/pgmj.65.770.913

Audit of mortality in upper gastrointestinal bleeding.

B D Katschinski 1, R F Logan 1, J Davies 1, M J Langman 1
PMCID: PMC2429572  PMID: 2616431

Abstract

The outcome in 1017 patients with haematemesis and malaena referred to two major hospitals in Nottingham within a 2-year period has been prospectively evaluated. Ninety one (9%) patients died during the time period under consideration and all but four were found to have been over 60 years of age. There were 13 (14%) deaths following rebleeding, of whom 5 (5%) could have been potentially avoided by alterations in management. Some improvement of mortality might result from intensive-care facilities with better management of transfusions and earlier detection of rebleeding allowing earlier endoscopy or surgery. The majority of patients (81%), however, died from concomitant disease which was exacerbated by gastrointestinal haemorrhage or bleeding developed in patients with an already existing end-stage disease. These results show that a reduction of mortality in patients with gastrointestinal bleeding is hampered by the high number of poor-risk patients. The rise in the proportion of elderly patients with this disorder seems to continue.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allan R., Dykes P. A study of the factors influencing mortality rates from gastrointestinal haemorrhage. Q J Med. 1976 Oct;45(180):533–550. [PubMed] [Google Scholar]
  2. Bleeding ulcers: scope for improvement? Lancet. 1984 Mar 31;1(8379):715–717. [PubMed] [Google Scholar]
  3. Devitt J. E., Brown F. N., Beattie W. G. Fatal bleeding ulcer. Ann Surg. 1966 Nov;164(5):840–844. doi: 10.1097/00000658-196611000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Double-blind placebo-controlled comparison of digoxin and xamoterol in chronic heart failure. The German and Austrian Xamoterol Study Group. Lancet. 1988 Mar 5;1(8584):489–493. [PubMed] [Google Scholar]
  5. Dronfield M. W., Atkinson M., Langman M. J. Effect of different operation policies on mortality from bleeding peptic ulcer. Lancet. 1979 May 26;1(8126):1126–1128. doi: 10.1016/s0140-6736(79)91803-8. [DOI] [PubMed] [Google Scholar]
  6. Dronfield M. W. Special units for acute upper gastrointestinal bleeding. Br Med J (Clin Res Ed) 1987 May 23;294(6583):1308–1309. doi: 10.1136/bmj.294.6583.1308-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Duggan J. M. Haematemesis patients should be managed in special units. Med J Aust. 1986 Mar 3;144(5):247–250. doi: 10.5694/j.1326-5377.1986.tb115886.x. [DOI] [PubMed] [Google Scholar]
  8. Hunt P. S., Francis J. K., Hansky J., Hillman H., Korman M. G., McLeish J., Marshall R., Schmidt G. Reduction in mortality from upper gastrointestinal haemorrhage. Med J Aust. 1983 Nov 26;2(11):552–555. doi: 10.5694/j.1326-5377.1983.tb122674.x. [DOI] [PubMed] [Google Scholar]
  9. Hunt P. S., Hansky J., Korman M. G. Mortality in patients with haematemesis and melaena: a prospective study. Br Med J. 1979 May 12;1(6173):1238–1240. doi: 10.1136/bmj.1.6173.1238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Johnston S. J., Jones P. F., Kyle J., Needham C. D. Epidemiology and course of gastrointestinal haemorrhage in North-east Scotland. Br Med J. 1973 Sep 29;3(5882):655–660. doi: 10.1136/bmj.3.5882.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Logan R. F., Finlayson N. D. Death in acute upper gastrointestinal bleeding. Can endoscopy reduce mortality? Lancet. 1976 May 29;1(7970):1173–1175. doi: 10.1016/s0140-6736(76)91554-3. [DOI] [PubMed] [Google Scholar]
  12. Madden M. V., Griffith G. H. Management of upper gastro-intestinal bleeding in a district general hospital. J R Coll Physicians Lond. 1986 Jul;20(3):212–215. [PMC free article] [PubMed] [Google Scholar]
  13. Morris D. L., Hawker P. C., Brearley S., Simms M., Dykes P. W., Keighley M. R. Optimal timing of operation for bleeding peptic ulcer: prospective randomised trial. Br Med J (Clin Res Ed) 1984 Apr 28;288(6426):1277–1280. doi: 10.1136/bmj.288.6426.1277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Somerville K., Faulkner G., Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet. 1986 Mar 1;1(8479):462–464. doi: 10.1016/s0140-6736(86)92927-2. [DOI] [PubMed] [Google Scholar]

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