Further haemorrhage after admission to hospital for gastrointestinal haemorrhage

During 1967 and 1968 817 episodes of acute alimentary tract haemorrhage were treated in Aberdeen hospitals. In 229 cases further haemorrhage occurred in hospital, with a mortality of 28.8%; the mortality among patients who did not have this complication was 7.8%. This was true of any kind of further haemorrhage. As judged by transfusion requirements and mortality the severity of the further haemorrhage was unaffected by its occurrence as haematemesis and melaena or as melaena only or by whether it took place before or after 48 hours from the time of admission. The occurrence of further haemorrhage did not appear to be affected by the sex or blood group of patients, by aspirin ingestion, or by a history of a previous haemorrhage.The effects of the occurrence of further haemorrhage, of the age being over 60 years, or of coincidental disease being present were of descending importance in regard to mortality.Among 151 patients with peptic ulcer and further haemorrhage half required urgent surgery and 20% died. Further haemorrhage is a dangerous condition and its occurrence should immediately signal the need for vigilance and for urgent consultation between physician and surgeon. Any delay in treatment entails increased mortality.