Original Article

Long-term Mortality of Patients Admitted to the Intensive Care Unit for Gastrointestinal Bleeding

Authors: Narasimh Gopalswamy, MD, Vikas Malhotra, MD, Niranjan Reddy, MD, Brij M. Singh, MD, Ronald J. Markert, PHD, Satya Sangal, PHD, Roy Jordan, BA

Abstract

Objectives: Long-term mortality data for gastrointestinal (GI) bleeders is scarce in the literature. The aim of this prospective study was to determine the long-term mortality of patients admitted to two intensive care units with a primary diagnosis of GI bleeding.


Methods: The charts of patients admitted to the medical intensive care unit (MICU) with GI bleeding were reviewed and the data of the patients’ first day in the MICU was used to calculate APACHE III and Charlson scores. A GI bleeding score was computed by combining endoscopic findings and units of blood transfused during patients’ MICU stay. Mortality data was obtained from the Vital Statistics Department of Montgomery County, Dayton, OH. Survival data and predictability of mortality based on these scores were assessed.


Results: Mean age of the 66 patient cohort was 58.6 years. Twenty-six of 51 patients with upper GI bleeding, five of seven patients with lower GI bleeding, and four of eight patients with unknown site of bleeding died within 7 years. Charlson score correlated significantly with the mortality prediction, whereas the APACHE III and bleeding scores did not.


Conclusions: All-cause and GI bleeding-related 7-year mortality for patients admitted to the MICU with GI bleeding was lower than the rates cited in the literature. The Charlson score was helpful in predicting mortality.


Key Points


* Long-term mortality (more than 30 days) of gastrointestinal bleeders is reported only scarcely in the literature.


* Seven-year data for a subset of patients with severe GI bleeding indicated that all-cause and GI bleeding-related long-term mortality were low.


* The Charlson score was helpful in predicting the long-term mortality of gastrointestinal bleeders.

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