Endoscopy 2006; 38(6): 581-585
DOI: 10.1055/s-2006-925313
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

The Outcome of Suspected Upper Gastrointestinal Bleeding With 24-Hour Access to Upper Gastrointestinal Endoscopy: A Prospective Cohort Study

C.  H.  Lim1 , D.  Vani2 , S.  G.  Shah1 , S.  M.  Everett3 , B.  J.  Rembacken3
  • 1 Department of Gastroenterology, Good Hope Hospital, Sutton Coldfield, UK
  • 2 Pinderfields General Hospital, Wakefield, UK
  • 3 Centre for Digestive Diseases, The General Infirmary at Leeds, Leeds, UK
Further Information

Publication History

Submitted 17 January 2005

Accepted after revision 3 October 2005

Publication Date:
27 April 2006 (online)

Background and Study Aim: The aim was to evaluate the 30-day mortality after endoscopy for suspected upper gastrointestinal bleed, following the implementation of national audit guidelines at our hospital.
Patients and Methods: All patients with suspected upper gastrointestinal bleeding, referred for endoscopy to our teaching hospital between October 2001 and December 2003, were included in a prospective cohort study.
Results: A total of 716 patients with suspected upper gastrointestinal tract haemorrhage were referred for urgent endoscopy. The median age was 69 years (interquartile range 51 - 80 years). Bleeding from peptic ulcer remained the single most common endoscopic diagnosis (40 %). The overall re-bleeding rate for all patients with a gastrointestinal haemorrhage was 10 %. The overall 30-day mortality rate was 14.6 %. This was not significantly different from the mortality rate in 1995 of 10.5 % (P = 0.11). Patients who died were significantly older (78 vs. 67 years, 95 %CI of the difference 5 to 12, P < 0.001). However, in only 29 % (30/105) was gastrointestinal haemorrhage stated in the death certificate as a factor which contributed to their death.
Conclusions: Our results show that implementing the good practice guideline has a limited impact on overall mortality because of contributing factors that are beyond the control of clinicians.

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C. H. Lim, M. D.

Department of Gastroenterology

Good Hope Hospital NHS Trust · Rectory Road · Sutton Coldfield B75 7RR · West Midlands · UK

Fax: +44 121 3786095

Email: Chee.Lim@goodhope.nhs.uk