Acute upper gastrointestinal bleeding: a population-based, five-year follow-up study.

• Published in: Scandinavian Journal of Gastroenterology
• Main Authors: Hreinsson, Johann P, Jonsson, Armann, Bjornsson, Einar S
• Other Authors: 1Department of Internal Medicine, Section of Gastroenterology and Hepatology, The Sahlgrenska University Hospital, Gothenburg, Sweden. 2Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital, Reykjavik, Iceland. 3Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2021
• Subjects: GI-bleeding; mortality; outcome; prognosis; rebleeding; survival; Meltingarfærasjúkdómar; Upper Gastrointestinal Tract; Hemorrhage; Iceland
• Online Access: http://hdl.handle.net/2336/621683; https://doi.org/10.1080/00365521.2020.1849384

To access publisher's full text version of this article click on the hyperlink below Objective: Data on long-term rebleeding risk and mortality in acute upper gastrointestinal bleeding (AUGIB) patients are scarce and comparison to controls are lacking. Aimsof the study were to assess long-term prognosis of AUGIB patients and compare to controls. Methods: A population-based retrospective case-control study conducted at the National University Hospital of Iceland and included all patients who underwent endoscopy in 2010-2011. AUGIB was defined as haematemesis or coffee ground vomiting leading to hospitalization or occurring in a hospitalized patient. Controls underwent endoscopy in 2010-2011, matched for sex/age. Rebleeding was defined as AUGIB >14 days up to five years after index bleeding. Results: Overall, 303 patients had AUGIB, mean age 67 (±18), controls66 years (±19), females, 51 and 46%, respectively. The five-year rebleeding rate for AUGIB patients was 13% (95%CI 9-17%), higher than the rate of bleeding events in controls, 3% (95%CI 1-5%; log-rank <0.001), hazard ratio (HR) 6.0 (95%CI 2.4-15) when correcting for comorbidities, NSAID's, PPI's and antithrombotics. The mortality of AUGIB patients at end of follow-up was higher when compared to controls, 39% (95%CI 49-33%) vs. 26% (95%CI 30-21%), log-rank <0.001, comorbidity-adjusted HR 1.4 (1.1-1.9). A subanalysis of non-variceal AUGIB yielded similar results in regard to rebleeding and mortality rates. Conclusions: AUGIB patients were at 6-fold risk of rebleeding compared to bleeding events in controls at five years of follow-up. Five-year mortality was higher in AUGIB patients when compared to controls even when correcting for age and comorbidities, suggesting that an episode of AUGIB indicates serious frailty. Keywords: GI-bleeding;; mortality;; outcome;; prognosis;; rebleeding; survival;.