Successful outpatient management of acute upper gastrointestinal hemorrhage: use of practice guidelines in a large patient series

Gastrointestinal Endoscopy
G F Longstreth, S P Feitelberg

Abstract

Acute upper gastrointestinal hemorrhage is a common reason for hospitalization. Clinical and endoscopic characteristics predict outcome. The aim of this study was to determine the characteristics and outcome of patients with acute upper gastrointestinal hemorrhage cared for without hospitalization. One hundred seventy-six consecutive patients in a staff-model health maintenance organization were selected for outpatient care based on absolute endoscopic and non-absolute clinical criteria. Clinical and endoscopic characteristics, British national audit "risk scores," and rates of recurrent bleeding, hospitalization, and mortality were determined. Mean patient age (+/- SD) was 56.4 +/- 16.0 years, and 106 patients (60%) were men. One hundred one (57%) had endoscopy within 2 days of the onset of hemorrhage. The mean initial hemoglobin concentration was 11.7 +/- 2.3 mg/dL. Ninety-seven patients (55%) had a peptic ulcer, and 57 (32%) had a British risk score greater than 2. Hospitalization, recurrent bleeding, and mortality occurred in two (1%), one (1%), and zero (0%) patients, respectively, during 16.0 +/- 10.8 months of follow-up. Many patients with acute upper gastrointestinal hemorrhage can be safely treated as outpatients using...Continue Reading

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Citations

Sep 19, 2001·Current Gastroenterology Reports·J P Terdiman
Nov 12, 2009·Current Gastroenterology Reports·Kevin A GhassemiDennis M Jensen
Oct 29, 2013·Best Practice & Research. Clinical Gastroenterology·Sunny H Wong, Joseph J Y Sung
Apr 30, 2004·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·R de Franchis
Jul 2, 2004·Gastrointestinal Endoscopy·Ananya Das, Richard C K Wong
Jul 2, 2004·Gastrointestinal Endoscopy·Ian M Gralnek, Gareth S Dulai
Oct 9, 2004·Gastrointestinal Endoscopy·Douglas G AdlerUNKNOWN ASGE
Jun 3, 2000·Gastroenterology Clinics of North America·T J Savides, D M Jensen
May 5, 2004·Best Practice & Research. Clinical Gastroenterology·David J Exon, S C Sydney Chung
Jun 8, 2004·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Fernando S VelayosJonathan P Terdiman
Dec 2, 1999·The New England Journal of Medicine·J Van Dam, W R Brugge
Aug 30, 2008·The New England Journal of Medicine·Ian M GralnekMarc Bardou
Jan 6, 2006·Journal of Clinical Gastroenterology·Javier P GisbertJosé María Pajares
Jun 20, 2007·Journal of Clinical Gastroenterology·Badih Joseph ElmunzerGrace H Elta
Aug 25, 2007·Journal of Gastroenterology and Hepatology·Doug Taupin
Aug 28, 2010·Journal of Gastroenterology and Hepatology·María ChaparroJavier P Gisbert
Apr 15, 2000·Journal of the American Academy of Nurse Practitioners·S A Carlson
Jun 22, 2012·World Journal of Gastroenterology : WJG·Adrian J Stanley
Jun 27, 2013·World Journal of Gastroenterology : WJG·Chang-Yuan WangDan-Dan Zhu
Nov 26, 2013·Clinics and Research in Hepatology and Gastroenterology·Jérôme RivoryJérôme Dumortier
Jul 25, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Stig B LaursenUNKNOWN Upper Gastrointestinal Hemorrhage International Consortium
Mar 8, 2013·The American Journal of Emergency Medicine·Cheng-Hsien WangI-Chuan Chen
Jul 18, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Stig Borbjerg LaursenOve B Schaffalitzky de Muckadell
May 26, 2012·Gastrointestinal Endoscopy·Joo Ha HwangUNKNOWN Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy
Dec 19, 2008·Lancet·Venkataraman Subramanian, Christopher J Hawkey
Dec 14, 2006·Advances in Surgery·Michael F McGeeJeffrey L Ponsky
Oct 24, 1998·Gastroenterology·G F Longstreth
Jul 6, 2007·BMC Gastroenterology·Michael LoydPhilip Jacobs
May 18, 2001·Best Practice & Research. Clinical Gastroenterology·M Simoens, P Rutgeerts
Aug 23, 2000·Baillière's Best Practice & Research. Clinical Gastroenterology·J F Riemann, A Rosenbaum
Jan 9, 2003·Gastrointestinal Endoscopy·Riccardo MarmoLivio Cipolletta
Mar 27, 2018·Scandinavian Journal of Gastroenterology·Rita Jiménez-RosalesEduardo Redondo-Cerezo
Oct 3, 2002·The American Journal of Gastroenterology·Dennis M Jensen
Jul 4, 2002·The American Journal of Gastroenterology·Alberto PardoEnrique Quintero
Nov 17, 2001·European Journal of Gastroenterology & Hepatology·C L Ch'ng, J G Kingham
Jul 9, 2010·The Cochrane Database of Systematic Reviews·Aravamuthan SreedharanPaul Moayyedi
Nov 25, 2011·European Journal of Gastroenterology & Hepatology·Conor LahiffDermot O'Toole
Dec 23, 2011·European Journal of Gastroenterology & Hepatology·Cara McLaughlinHarry R Dalton

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