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Mallory-Weiss tear: predisposing factors and predictors of a complicated course

D Y Kortas1, L S Haas, W G Simpson

  • 1Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, USA.

The American Journal of Gastroenterology
|November 6, 2001
PubMed
Abstract

Insights

Active bleeding during initial endoscopy predicts a complicated Mallory-Weiss tear (MWT) course. Early endoscopy aids in stratifying MWT patients for timely intervention, improving outcomes.

Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Mallory-Weiss tears (MWT) can lead to complicated courses, but predictors are not well-established.
  • Identifying risk factors for MWT and predictors of its complications is crucial for patient management.

Purpose of the Study:

  • To identify risk factors associated with developing a Mallory-Weiss tear.
  • To determine factors that predict a complicated course following a Mallory-Weiss tear.

Main Methods:

  • Retrospective review of 73 cases from university and Veterans Affairs hospital endoscopy databases.
  • Analysis of proposed risk factors including alcohol use, NSAID use, and hiatal hernia.
  • Evaluation of predictors for complicated course using Mann-Whitney U test or Fisher exact test, with complications defined by transfusion, rebleeding, or intervention.

Main Results:

  • Alcohol use was the most common risk factor (44%).
  • A complicated course occurred in 23% of patients.
  • Lower admission hematocrit (p = 0.009) and active bleeding at initial endoscopy (p = 0.013) were associated with complicated courses.

Conclusions:

  • Active bleeding during initial endoscopy is a significant predictor of a complicated Mallory-Weiss tear course.
  • Early endoscopic evaluation is recommended for risk stratification and timely intervention in MWT patients.

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