REBLEEDING RATE AND THE NEED OF BLOOD TRANSFUSION ARE HIGHER IN PATIENTS WITH UPPER GASTROINTESTINAL TUMOR BLEEDING THAN IN PATIENTS WITH PEPTIC ULCER BLEEDING.

Abstract

The aim of our 5-year study (from January 2008 to December 2012) was to compare the incidence of peptic ulcer bleeding (PUB) to bleeding from tumors of the upper gastrointestinal tract. The percentage of re-bleeding within the first 30 days of hospital admission, as well as the need of blood transfusions, are also reported. Statistical data were collected on 2198 patients who were treated in our emergency department due to upper gastrointestinal bleeding (UGIB) in the form of melena or hematemesis. Upper endoscopy performed within 24 hours of arrival revealed that 796 (36.2%) patients had a peptic ulcer, while the diagnosis of upper gastrointestinal tumor bleeding (UGITB) was verified in 61 (2.8%) patients. During the five-year study, it was shown that men had a higher prevalence of bleeding compared to women (PUB 62.3% vs. UGITB 52.5%). The cumulative incidence of UGIB was 126/100,000. It was found that the largest number of bleeding tumors were located in the stomach (n=58, 95%), with most of them being malignant tumors (n=55, 90%), specifically adenocarcinomas (n=48, 87.3%). The percentage of re-bleeding was lower (9.7% vs. 19.7%, p<0.01) and blood transfusions were less often required (49.5% vs. 75.4%, p<0.01) in PUB. Due to uncontrolled bleeding (5.9% vs. 3.3%, p<0.01), surgical treatment was more often required in cases of PUB, as well as larger volumes of blood transfusion. Patients with PUB had a lower rate of re-bleeding, required surgical intervention more often, and required red blood cell transfusions less frequently.