Prediction of recurrent bleeding after endoscopic haemostasis in non-variceal upper gastrointestinal haemorrhage

K. G. Park, R. J. C. Steele, J. Mollison, T. J. Crofts

    Research output: Contribution to journalArticle

    53 Citations (Scopus)

    Abstract

    Endoscopic haemostasis by injection of adrenaline was attempted in 135 consecutive patients with active upper gastrointestinal bleeding. Initial haemostasis was obtained in 127 patients following injection of 5-15 ml 1:10,000 adrenaline; eight patients in whom haemostasis was not achieved underwent immediate laparotomy. There was further haemorrhage in 25 patients, which was successfully treated by further injection of adrenaline in ten. Fifteen patients had major rebleeding requiring emergency surgery. Stepwise logistic regression analysis identified three factors that, taken together, were highly predictive of the need for surgery: pulse rate on admission, the position of the ulcer and whether the patient was obese. A scoring system was derived from the logistic analysis equation that was found to predict correctly the need for emergency surgery in 84 per cent of patients. In patients with a high probability of rebleeding surgery should be considered after initial endoscopic haemostasis and stabilization. In the majority of patients endoscopic treatment alone is sufficient for permanent haemostasis.
    Original languageEnglish
    Pages (from-to)1465-1468
    Number of pages4
    JournalBritish Journal of Surgery
    Volume81
    Issue number10
    DOIs
    Publication statusPublished - 1994

    Keywords

    • Adolescent
    • Adult
    • Aged
    • Aged, 80 and over
    • Endoscopy, Gastrointestinal
    • Epinephrine
    • Female
    • Gastrointestinal Hemorrhage
    • Hemostasis, Surgical
    • Humans
    • Injections
    • Male
    • Middle Aged
    • Obesity
    • Peptic Ulcer
    • Pulse
    • Recurrence
    • Regression Analysis
    • Risk Factors

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