Epidemiology and Course of Gastrointestinal Haemorrhage in North-east Scotland

Johnston, Shirley J.; Jones, Peter F.; Kyle, James; Needham, C. D.

doi:10.1136/bmj.3.5882.655

Cited by 90 publications

(36 citation statements)

References 10 publications

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“…Upper gastrointestinal (UGI) bleeding is a common disorder affecting over 100 per 100 000 population yearly [1][2][3][4][5][6][7] . The most common etiologies include peptic ulcer disease, mucosal erosive disease and variceal bleeding [8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

Enns

Gagnon²,

Barkun³

et al. 2006

WJG

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AIM:To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS:We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used χ 2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS:

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Section: Introductionmentioning

confidence: 99%

Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

Enns

Gagnon²,

Barkun³

et al. 2006

WJG

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“…There was a tendency for UGI bleeding to present during the winter months whether or not the underlying cause was duodenal ulcer. A seasonal tendency has been described before [7,21] but its cause remains unclear. Duodenal ulcer has frequently been found to be the most common cause of bleeding [5,6,9,15,22] although gastric ulcer [23] and gastritis [24] have at times been found to be more frequent than duodenal ulcer.…”

Section: Discussionmentioning

confidence: 99%

Upper Gastrointestinal Hemorrhage in Jordan: An Analysis of Causes, Characteristics and Outcome

Toukan

1991

Ann Saudi Med

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Two hundred twenty-four patients presenting consecutively with massive upper gastrointestinal hemorrhage were endoscoped within 24 hours to determine the site of bleeding. Outcome was evaluated in relation with presenting variables. Duodenal ulcer was found to be the most common source of bleeding. Endoscopy demonstrated 33% of all patients had more than one potential bleeding site. Patients with duodenal ulcer were significantly younger than patients with gastric ulcer (41 ± 17 years versus 58 ± 19 years, respectively). There was a tendency for upper gastrointestinal hemorrhage to present more often in the winter months. Eighty-one percent of duodenal ulcer patients and 57% of gastric ulcer patients had dyspepsia prior to the presentation of bleeding. There was a strong correlation between presence of concomitant disease and the age of the patient. Forty-three percent of patients had ingested aspirin or other nonsteroidal anti-inflammatory agents in the week prior to the bleed compared with 18% in a control group. All nine patients with bleeding diathesis (including that induced by anticoagulant maintenance therapy) had an underlying source of bleeding. Sixty-nine percent of the patients had spontaneous resolution of their bleeding within 24 hours while 25% underwent emergency surgery. The overall mortality rate was 10%. Age, underlying chronic liver disease, and transfusion requirements were foùnd to be independent predictors of mortalitv when assessed bv multivariate regression analysis. AU Toukan, Upper Gastrointestinal Hemorrhage in Jordan: An Analysis of Causes, Characteristics and Outcome. 1991; 11(5): 539-546Upper gastrointestinal (UGI) hemorrhage remains a common and important acute medical problem. Correct management decisions based upon accurate clinical data must be made at the right time. In spite of modern methods of diagnosis and care, mortality has remained essentially unchanged in the past 50 years, ranging from 5 to 20% [1][2][3][4][5][6][7][8][9][10]. On the other hand, the patient population over the same time period is also getting older, thus implying that mortality in younger age groups may be decreasing [2].This study was undertaken to: (a) study the patient population and their characteristics in Jordan, (b) to determine the underlying causes of the bleeding in these patients, and (c) to determine which factors influence outcome in relation tomortality, emergency surgery, or spontaneous resolution of the bleeding episode.Endoscopic examination is now the procedure of choice with which to establish the cause of bleeding [11][12][13]. Endoscopy was performed in the first 24 hours in order to increase the likelihood of identifying the bleeding site [14]. As the reason for admission to a hospital has been found to be an important variable [15], only those patients presenting with UGI bleeding from outside the hospital were included. Also, inpatients have a higher mortality than outpatients [3,16,17], a factor that is important in deciding criteria for entry into a study and when comparing ou...

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Section: Case Seriesmentioning

confidence: 99%

“…Hemorrhage intensity was assessed as mild, moderate, or severe according to the criteria proposed by Johnston et al [6] . The classification of digestive hemorrhage intensity according to these criteria [6] is summarized in Table 2. During endoscopic examination, the caliber of esophageal varices was classified as small, medium, or large (alternatively, this assessment was made according to the descriptions made by the performing physicians) according to Paquet's classification [7] .…”

Section: Case Seriesmentioning

confidence: 99%

Comparison between endoscopic sclerotherapy and band ligation for hemostasis of acute variceal bleeding

Luz¹,

Maluf‐Filho²,

Matuguma³

et al. 2011

WJG

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AIM:To compare band ligation (BL) with endoscopic sclerotherapy (SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS:A prospective, randomized, single-center study without crossover was conducted. After endoscopic diagnosis of esophageal variceal rupture, patients were randomized into groups for SCL or BL treatment. Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point, with a maximum volume of 20 mL. For BL patients, banding at the rupture point was attempted, followed by ligation of all variceal tissue of the distal esophagus. Primary outcomes for both groups were initial failure of bleeding control (5 d), early re-bleeding (5 d to 6 wk), and complications, including mortality. From May 2005 to May 2007, 100 patients with variceal bleeding were enrolled in the study: 50 SCL and 50 BL patients. No differences between groups were observed across gender, age, ChildPugh status, presence of shock at admission, mean hemoglobin levels, and variceal size. RESULTS:No differences were found between groups for bleeding control, early re-bleeding rates, complications, or mortality. After 6 wk, 36 (80%) SCL and 33 (77 %) EBL patients were alive and free of bleeding. A statistically significant association between Child-Pugh status and mortality was found, with 16% mortality in Child A and B patients and 84% mortality in Child C patients (P <0.001). CONCLUSION:Despite the limited number of patients included, our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.

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Epidemiology and Course of Gastrointestinal Haemorrhage in North-east Scotland

Cited by 90 publications

References 10 publications

Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

Upper Gastrointestinal Hemorrhage in Jordan: An Analysis of Causes, Characteristics and Outcome

Comparison between endoscopic sclerotherapy and band ligation for hemostasis of acute variceal bleeding

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