Auditing mortality from upper gastrointestinal haemorrhage: impact of a high dependency unit

J R Coll Physicians Lond. 1998 May-Jun;32(3):246-50.


Background: A retrospective audit conducted at our district general hospital indicated that mortality from upper gastrointestinal (GI) haemorrhage was above that reported from nearby centres.

Objectives: To assess the impact of establishing a high dependency unit (HDU) and agreed management protocol on subsequent mortality from upper GI haemorrhage at our hospital.

Design: Prospective audits were conducted before and after the establishment of an HDU. All acute admissions, as well as established inpatients with haematemesis and/or melaena, were examined for fitness for endoscopy, comorbidity, underlying diagnosis and the need for surgery.

Subject: Over a two-year period, 524 patients were studied in the two audits. Risk scores were calculated and the 30-day mortality from all causes assessed.

Results: There was a trend towards higher age and comorbidity during the second audit. Mortality was 9% and 10% during the first and second audits, respectively.

Conclusions: An increasing proportion of patients with bleeding are elderly and have associated comorbidity. Establishment of an HDU and agreed protocol did not reduce mortality at our centre.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Endoscopy
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / mortality*
  • Hematemesis / diagnosis
  • Hospital Units
  • Humans
  • Male
  • Medical Audit
  • Melena / diagnosis
  • Middle Aged
  • Retrospective Studies
  • Time Factors