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Acute upper gastrointestinal bleeding: a population-based, five-year follow-up study.

Johann P Hreinsson1, Armann Jonsson2,3, Einar S Bjornsson2,3

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Summary

Patients with acute upper gastrointestinal bleeding (AUGIB) face a significantly higher risk of rebleeding and mortality. This study highlights that AUGIB indicates serious underlying health issues, necessitating closer patient monitoring.

Keywords:
GI-bleeding;mortality;outcome;prognosis;rebleedingsurvival;

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Research

Background:

  • Long-term prognosis data for acute upper gastrointestinal bleeding (AUGIB) patients are limited.
  • Comparative studies of AUGIB patients versus control groups are lacking.

Purpose of the Study:

  • To evaluate the long-term prognosis of patients experiencing acute upper gastrointestinal bleeding.
  • To compare the rebleeding rates and mortality of AUGIB patients against a matched control group.

Main Methods:

  • A population-based retrospective case-control study was conducted.
  • Patients undergoing endoscopy between 2010-2011 were included.
  • Acute upper gastrointestinal bleeding was defined by specific clinical criteria; controls were matched for age and sex.

Main Results:

  • The five-year rebleeding rate for AUGIB patients was 13%, significantly higher than the 3% in controls (HR 6.0).
  • Five-year mortality was higher in AUGIB patients (39%) compared to controls (26%) (HR 1.4), even after adjusting for comorbidities.
  • Subanalysis of non-variceal AUGIB showed similar increased risks for rebleeding and mortality.

Conclusions:

  • Acute upper gastrointestinal bleeding patients have a six-fold increased risk of rebleeding over five years.
  • AUGIB is associated with increased long-term mortality, suggesting it reflects significant patient frailty.