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News

Poor survival after GI bleed is not due to rebleeding

Rebleeding after an initial episode of lower GI bleeding occurs in a small percentage of individuals and although survival is poor for patients, few patients die as a direct consequence of hemorrhage, reports November's issue of the American Journal of Surgery.

News image

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Previous studies of acute lower gastrointestinal bleeding (LGIB) have focused on evaluation and therapy.

Measurement of long-term outcome has been rare.

Dr Thomas Anthony and colleagues from Virginia, America, undertook a study with the purpose of documenting rebleeding and survival rates in patients with acute LGIB.

The research team performed a retrospective review of all patients undergoing technetium-labeled red blood cell scans for LGIB from January of 1997 to December of 2002.

The researchers defined rebleeding as identification of enteric bleeding requiring a transfusion 2 or more weeks after the initial bleeding episode.

Out of 36 patients, 4 died of surgical complications and 1 patient as a direct result of hemorrhage
American Journal of Surgery

In total, 119 patients met inclusion criteria and were included in the study.

The research group documented rebleeding in 14 of 102 patients surviving for more than 2 weeks.

The actuarial rebleeding rate was 15% at 2 years.

No factors were identified that portended a higher likelihood of rebleeding.

The researchers found that the 30-day mortality was 18% and the median survival was 60 months for the entire cohort.

The team noted that out of the 36 patients in whom cause of death was documented, 4 died of surgical complications and a single patient died as a direct result of hemorrhage.

Dr Anthony concluded, "Rebleeding after an initial episode of LGIB occurs in a small percentage of individuals."

"Although survival is poor for patients with LGIB, few patients die as a direct consequence of hemorrhage."

American Journal of Surgery; 2004: 188 (5): 485-490
18 November 2004

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