Changes in characteristics and outcome of acute upper gastrointestinal haemorrhage: a comparison of epidemiology and practices between 1996 and 2000 in a multicentre French study

Abstract

Our time-trend evaluation of changes in AUGIH characteristics revealed that peptic ulcer and varices were still the two most frequent bleeding lesions. In patients with varices bleeding, endoscopic ligation became the routine standard treatment instead of varices sclerosis. The mortality rate decreased significantly over the 5-year study period in the whole group and particularly in the subgroup of cirrhotic patients.

Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

“…However, bleeding from ruptured EVs is still the leading cause of death in patients with cirrhosis. In recent studies, mortality figures were between 11% and 20% within six weeks of the bleeding episode (8)(9)(10)(11). Therefore, prevention of variceal bleeding should be an important goal.…”

Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

“…[11] According to a report by Fiore et al [12] 70% of AUGIH cases had a history of alcohol abuse. In the present study the rate of alcohol abuse among the patients was 6.7%.…”

“…[17] This situation should be considered in this age group. Fiore et al [12] reported the rate of patients with a previous bleeding as 19-23%. Timraz et al [11] reported past AUGIH in 12% of patients in their study.…”

Epidemiology of Upper Gastrointestinal Bleeding

“…25 Other non variceal haemorrhage studies from Spain(n=17,663), 5 the Netherlands (n=1,720), 3 Greece (n=1,304) 147 , France (n=1,165) 61 and Italy (n=1,126), 26 did not identify reductions in non variceal inpatient mortality. Although these were large studies they may have been underpowered to detect a change, and none of them adjusted the trends in case fatality for changes in co-morbidity.…”

“…The low mortality identified in this study (3.5%) is similar to other North American, 12 and Mediterranean studies, 5,147 but is much lower than other European studies. 3,26,61 However, a study of Medicare patients in the US found that the proportion being managed as outpatients varied between states from 18.6%-45.3%. 35 These differences in practice would lead to differences in inpatient study populations and confound comparisons with countries such as England where outpatient management is not routine.…”