Upper gastrointestinal hemorrhage in cirrhosis: timing and indications for active intervention

The medical treatment of upper gastrointestinal hemorrhage was assessed in 101 patients with alcoholic liver disease. Mortality was proportional to the number of blood transfusions required, regardless of the severity of liver disease. Overall mortality was 73% when transfusion requirements exceeded four units, compared with 19% when less than this amount was required (p less than 0.05). A more direct approach to the control of variceal hemorrhage is indicated when blood loss reaches 21.