Related Experiment Videos
Acute upper gastrointestinal bleeding: a population-based cohort study from Southern Iceland
Vigdis S Sverrisdottir1, Johann P Hreinsson2,3, 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.
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.
Related Concept Videos
01:30Peptic Ulcer Disease I: Introduction
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:25Peptic Ulcer Disease I: Introduction
Peptic ulcer disease (PUD) involves breaks in the gastrointestinal tract's mucosal lining, primarily in the stomach and duodenum, with less frequent occurrences in the lower esophagus or near the pylorus.Ulcers can be acute or chronic. Acute ulcers are short-lived with minimal inflammation and heal quickly after the irritant is removed. Chronic ulcers persist, may recur, and often cause scarring due to ongoing tissue damage. Superficial erosions affect only the mucosal layer and are called...
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:23Gastritis III: Clinical Manifestations and Management
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:24Esophageal Varices-I: Introduction
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...