Initial Assessment and Resuscitation in Nonvariceal Upper Gastrointestinal Bleeding

Gastrointest Endosc Clin N Am. 2015 Jul;25(3):429-42. doi: 10.1016/j.giec.2015.02.006. Epub 2015 Apr 18.


Acute nonvariceal upper gastrointestinal bleeding remains an important cause of hospital admission with an associated mortality of 2-14%. Initial patient evaluation includes rapid hemodynamic assessment, large-bore intravenous catheter insertion and volume resuscitation. A hemoglobin transfusion threshold of 7 g/dL is recommended, and packed red blood cell transfusion may be necessary to restore intravascular volume and improve tissue perfusion. Patients should be risk stratified into low- and high-risk categories, using validated prognostic scoring systems such as the Glasgow-Blatchford, AIMS65 or Rockall scores. Effective early management of acute, nonvariceal upper gastrointestinal hemorrhage is critical for improving patient outcomes.

Keywords: AIMS65; Gastrointestinal bleeding; Glasgow-Blatchford score; Nonvariceal hemorrhage; Risk stratification.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Blood Transfusion / methods*
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Hemorrhage / epidemiology*
  • Gastrointestinal Hemorrhage / therapy*
  • Global Health
  • Humans
  • Incidence
  • Prognosis
  • Resuscitation / methods*
  • Risk Assessment*