AB193. Upper gastrointestinal bleeding: audit of a single centre experience. patient characteristics, diagnoses and outcomes

Background: Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency which has a 10% hospital mortality rate. 83% of cases present as new admissions to the Emergency Department (ED). Multi-centre UK Audits have compiled patient demographics. We aim to compile similar data within an Irish context. This includes describing the characteristics, diagnoses and clinical outcomes of patients presenting with acute UGIB.

Methods: All patients who presented to the ED in Midlands Regional Hospital Tullamore with UGIB during a 1-year period [2017–2018] were included. Patients were identified by Hospital In-Patient Enquiry (HIPE) database coding.

Results: Seventy-three patients were included in the study. 42.5% of patients were female (n=31) and 57.5% were male (n=42). The median age was 75 years (25th, 75th percentiles: 18 to 95 years). All patients required hospital admission [5.5% (n=4) requiring ICU admission]. The most common cause of UGIB was gastritis (31%, n=23). 22% (n=16) had a previous GI bleed, with 43% (n=32) having no previous GI history. 60% (n=44) were taking antiplatelets or anticoagulants with 8% (n=6) taking NSAIDS. 46% (n=34) of patients had an OGD, 16% (n=12) of which performed within 24 hrs. Intervention during OGD was required in 1.4% (n=1). Bleeding source was identified in 10% (n=80). Red blood cell transfusions were required in 37% (n=4). 67% (n=49) were treated with IV PPI. Death occurred in 1.4% (n=1).

Conclusions: This audit highlighted demographics of UGIB patients. Identifying characteristics, diagnostic and initial therapeutic approach. Recognising these features may assist in future triage and management of UGIB.

Keywords: Glasgow blatchford score; upper gastrointestinal haemorrhage (UGIB); Hospital In-Patient Enquiry (HIPE)