PURPOSE: To determine the characteristics and clinical outcome of patients admitted to the Intensive Care Unit (ICU)with gastrointestinal bleeding(GIB) in a community teaching hospital.
METHODS: Retrospective analysis of all medical records of patients admitted to the ICU from January to December 2003 with the diagnosis of GIB were evaluated on diagnostic results, re-bleeding, rate of transfusion and relevant laboratory findings. Patients who developed GIB while in ICU and without definite diagnostic studies were excluded.
RESULTS: There were 50 patients with upper GIB (UGIB) and 28 patients with lower GIB. LGIB patients were significantly older than UGIB patients (76.7 +/- 10.7 vs 66.2 +/- 16.9 years; p = 0.004) and consisted mainly of women (60.7% vs 30.0%; p = 0.008). The severity of anemia on admission did not differ significantly in both groups (p=0.095) nor did the rate of transfusion (p=0.398). GIB patients who were transfused had lower hemoglobin levels than those who were not transfused (9.5 +/- 2.6 vs 11.5 +/- 2.3 g/dl; p=0.013). Patients who re-bled in ICU or the hospital floor had significantly higher transfusion mean ranks than patients who did not re-bleed (p=0.011, p=0.033). In both LGIB and UGIB, there was no significant difference in the length of ICU stay (p =0.679). However, both re-bleeding (p = 0.002) and transfusion (p = 0.041) significantly increased length of ICU stay. There was no significant difference in mortality rate in both patient groups (p=0.078).
CONCLUSION: LGIB patients were older in age and predominantly women as opposed to UGIB patients. The severity of anemia on admission did not differ in both groups but patients who got transfused had significantly lower hemoglobin levels. Transfusion rates were higher in patients who re-bled, and both these factors separately resulted in increased ICU stay. There was no difference in mortality rate in the two patient groups.
CLINICAL IMPLICATIONS: There is a higher prevalence of lower gastrointestinal bleeding in the elderly women. Transfusion and re-bleeding tend to increase the length of stay in ICU.
DISCLOSURE: Arun Devakonda, No Financial Disclosure Information; No Product/Research Disclosure Information