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Clin Gastroenterol Hepatol. 2006 Dec;4(12):1459-1466. Epub 2006 Nov 13.

Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993-2003.

Author information

1
Section of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, Manitoba. targowni@cc.umanitoba.ca

Erratum in

  • Clin Gastroenterol Hepatol. 2007 Mar;5(3):403.

Abstract

BACKGROUND & AIMS:

ANVUGIB is a common reason for hospital admission and has been traditionally associated with a mortality rate of 5%-10%. There have been numerous innovations in the prevention and management of ANVUGIB in recent years, although the effect of these innovations on ANVUGIB incidence and outcomes is unknown.

METHODS:

We used the Statistics Canada's Health Person Oriented Information Database [corrected], which contains data characterizing every inpatient hospital admission in Canada between 1993 and 2003. We identified admissions consistent with nonvariceal upper gastrointestinal bleeding using both a broad and narrow ICD-9/ICD-10-based definition. Data were extracted concerning patient demographics, incidence of surgery for complications of upper gastrointestinal bleeding, and overall mortality.

RESULTS:

Between 1993 and 2003, ANVUGIB incidence decreased from 77.1 cases to 53.2 per 100,000/y for the broad definition, and from 52.4 to 34.3 cases per 100,000/y for the narrow definition. ANVUGIB incidence rose slightly in 2000, coincident with the introduction of COX-2 inhibitors. The proportion of ANVUGIB subjects requiring surgical intervention declined over the 10 years from 7.1% to 4.5%, although the rate of decline did not increase after the introduction of intravenous proton pump inhibitors (IV PPIs). The mortality rate remained steady at approximately 3.5%.

CONCLUSIONS:

The incidence of ANVUGIB and the need for operative intervention has been steadily declining since 1993. ANVUGIB-associated mortality remained constant, although at a rate lower than traditionally reported. The impact of IV PPIs on mortality and operative intervention on a population-wide basis is likely minimal.

PMID:
17101296
DOI:
10.1016/j.cgh.2006.08.018
[Indexed for MEDLINE]
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