[Lethality after gastroduodenal ulcer bleeding]

The retrospective analysis (2006-2010 yy) of treatment of 895 patients with gastroduodenal ulcer bleeding was conducted. Lethal outcome was registered in 220 (24.6%) patients, of them directly of the ulcer bleeding died 45 (5%). The Rockall score was used as universal prognostic instrument. Of 164 lethal outcomes, did not directly connected to the ulcer bleeding, the etiological distribution was as follows: multiple organ failure - 36% (n=59), cardiovascular diseases - 24.4% (n=40), inveterate oncology - 15.9% (26). Of 45 deaths from bleeding, only 4 patients died of the uncontrolled bleeding, whereas 18 (45%) died after the emergency surgery. Signs of hemorrhagic shock were registered in 60% of died patients (in comparison with 18% among the survived). Bleeding reccurrence was registered in 28.6% of died patients (in comparison with 11% among the survived). The use of the Rockall score confirmed its prognostic value: the mean score was 4.3±2.12 points among the survived patients, whereas among the died patients it was 7.16±2.35 points (p=0.001). Authors conclude, that the leading reasons of death, considering the bleeding itself, were the hemorrhagic shock and recurrent bleeding. Though, about 80% of patients are dying of reasons, do not directly connected to the bleeding episode, but of concomitant diseases (multiple organ failure, cardiovascular and oncologic diseases). The least, nevertheless, leads to the wrong formulation of the final diagnosis and incorrect interpretation of the etiology of death.