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Acute upper gastrointestinal bleeding: a population-based cohort study from Southern Iceland.

Vigdis S Sverrisdottir¹, Johann P Hreinsson^2,3, Arnar B Ingason⁴

¹Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Scandinavian Journal of Gastroenterology

|June 29, 2026

Summary

Acute upper gastrointestinal bleeding (AUGIB) incidence in Iceland is low and decreasing. Most AUGIB patients were admitted, but triage was effective, with few interventions for discharged individuals.

Keywords:

Gastrointestinal hemorrhage clinical outcomes endoscopy hematemesis incidence melena

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Area of Science:

Gastroenterology
Epidemiology
Public Health

Background:

Acute upper gastrointestinal bleeding (AUGIB) is a frequent cause of emergency room visits, associated with significant morbidity and mortality.
Existing research often overlooks outcomes for patients not requiring hospital admission.
This study addresses the gap by examining all AUGIB presentations, irrespective of admission status.

Purpose of the Study:

To determine the incidence and outcomes of all acute upper gastrointestinal bleeding (AUGIB) presentations.
To assess the utilization of prediction models in managing AUGIB cases.
To evaluate patient characteristics, treatment patterns, and mortality rates across admitted and non-admitted groups.

Main Methods:

Retrospective chart review of all AUGIB cases at Landspitali University Hospital, Iceland (2017-2023).
Calculation of AUGIB incidence using Poisson regression for the hospital's catchment area.
Analysis of patient demographics, endoscopy findings, outcomes, and survival using Kaplan-Meier methods.

Main Results:

A total of 1129 AUGIB cases were identified among 1017 individuals, with an overall annual incidence of 75/100,000, showing a decreasing trend.
Admitted patients (67%) were significantly more likely to undergo endoscopy and receive blood transfusions compared to non-admitted patients.
Thirty-day all-cause mortality was higher in admitted patients (6.7%) versus non-admitted (0.9%), with the Glasgow-Blatchford score reported in only 1% of cases.

Conclusions:

The incidence of acute upper gastrointestinal bleeding (AUGIB) in Iceland is low and declining.
A significant proportion of AUGIB patients were managed without hospital admission, indicating effective initial triage.
Despite limited use of prediction models like the Glasgow-Blatchford score, patient management appeared appropriate, with minimal interventions for discharged individuals.