Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit
- Sarah A Hearnshaw1,
- Richard F A Logan2,
- Derek Lowe3,
- Simon P L Travis4,
- Mike F Murphy5,
- Kelvin R Palmer6
- 1Department of Gastroenterology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- 2Division of Epidemiology and Public Health, Nottingham Digestive Diseases Centre, University of Nottingham, UK
- 3Clinical Evaluation and Effectiveness Unit, Royal College of Physicians of London, London, UK
- 4Department of Gastroenterology, John Radcliffe Hospital, Oxford, UK
- 5University of Oxford, Oxford, UK
- 6Western General Hospital, Edinburgh, UK
- Correspondence to Professor Richard F Logan, University of Nottingham, Division of Epidemiology & Public Health, Queen's Medical Centre, Nottingham, NG7 2UH, UK;
Contributors Dr S Hearnshaw designed the study, ran the data collection, analysed the data and contributed to writing the manuscript. Mr D Lowe contributed to the design of the study, and carried out the statistical analysis. Professor R Logan designed the study, advised on data analysis and contributed to writing the manuscript. Dr S Travis contributed to the study design and writing of the manuscript. Professor M Murphy designed the study and contributed to writing of the manuscript. Dr K Palmer designed the study, contributed to writing of the manuscript and is the guarantor.
- Revised 22 February 2011
- Accepted 23 February 2011
- Published Online First 13 April 2011
Objective To describe the patient characteristics, diagnoses and clinical outcomes of patients presenting with acute upper gastrointestinal bleeding (AUGIB) in the 2007 UK Audit.
Design Multi-centre survey.
Setting All UK hospitals admitting patients with AUGIB.
Participants All adults (>16 years) presenting in or to UK hospitals with AUGIB between 1 May and 30 June 2007.
Results Data on 6750 patients (median age 68 years) was collected from 208 participating hospitals. New admissions (n=5550) were younger (median age 65 years) than inpatients (n=1107, median age 71 years), with less co-morbidity (any co-morbidity 46% vs 71%, respectively). At presentation 9% (599/6750) had known cirrhosis, 26% a history of alcohol excess, 11% were taking non-steroidal anti-inflammatory drugs and 28% aspirin. Peptic ulcer disease accounted for 36% of AUGIB and bleeding varices 11%. In 13% there was evidence of further bleeding after the first endoscopy. 1.9% underwent surgery and 1.2% interventional radiology for AUGIB. Median length of stay was 5 days. Overall mortality in hospital was 10% (675/6750, 95% CI 9.3 to 10.7), 7% in new admissions and 26% among inpatients. Mortality was highest in those with variceal bleeding (15%) and with malignancy (17%).
Conclusions AUGIB continues to result in substantial mortality although it appears to be lower than in 1993. Mortality is particularly high among inpatients and those bleeding from varices or upper gastrointestinal malignancy. Surgical or radiological interventions are little used currently.
- Acute gastrointestinal bleeding
- gastrointestinal endoscopy
- bleeding peptic ulcer
- gastrointesinal endoscopy
- gastrointestinal bleeding
Funding The clinical research fellow was funded by NHS Blood and Transplant and the British Society of Gastroenterology. No other funding was obtained. Professor M Murphy and Dr K Palmer are representatives of the NHS Blood and Transplant Service and the British Society of Gastronenterology, respectively, and were instrumental in obtaining the funding for the clinical research fellow for this audit to be conducted. The participating hospitals and clinicians received no funding.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.