Authors
Marya, Neil B.Jawaid, Salmaan
Gondal, Bilal
Maranda, Louise
Marshall, Christopher A.
Foley, Anne
Charpentier, Joseph
Singh, Anupam
Cave, David R.
Document Type
Poster AbstractPublication Date
2014-05-20
Metadata
Show full item recordAbstract
Background: For decades the diagnosis and management of gastrointestinal bleeding (GIB) has been based largely on endoscopy. Studying a large cohort of patients presenting to the ED we may find cost-effective alternatives in the management of GIB. We analyzed the epidemiology and initial disposition of all patients who presented to our ED from the perspective of hematemesis versus non-hematemesis, to identify patterns among each cohort’s presentations to aid in this. Methods: Retrospective analysis of medical records for 338 patients presenting to the UMass ED. Two cohorts were identified: those with hematemesis (G1) or non-hematemesis (G2). Results: 105 patients presented to the ED with hematemesis (G1), 233 patients presented with non-hematemesis GIB (G2). G1 was younger than G2 (54.4 years vs. 65.6 years, p<0.001). There were more males in G1 vs. G2 (61% vs. 53%, p=0.154). Comorbities in G1 were liver disease (21%), alcohol abuse (20%), and diabetes (11%). Comorbities in G2 were coronary artery disease (22%), atrial fibrillation (13.7%), and diverticulosis (8%). More patients in G2 than G1 used Coumadin (23% vs. 7%, p<0.001), anti-platelet agents (12% and 3%, p<0.004), and NSAIDs (40% and 32%y, p=0.203). Admission hematocrit was greater in G1 compared to G2 (34.1 vs. 30.0, p<0.001). INR was greater in G2 compared to G1 (1.7 vs. 1.3, p=0.03). BUN was greater in G2 compared to G1 (30.2 vs. 23.6, p=0.021). More patients in G2 were admitted compared to G1 (89.6% vs. 78.1%, p=0.019). More were admitted to the ICU in G1 compared to G2 (46% vs. 38%, p=0.237).Discussion: This study uses a novel approach that elicits different patterns than the traditional delineation of upper versus lower GIB. These results may lead to new decision-making in patients presenting with GIB, allowing for new diagnostic and management paradigms, resulting in cost-effective care.DOI
10.13028/3af7-sy32Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28015Notes
Abstract of poster presented at the 2014 UMass Center for Clinical and Translational Science Research Retreat, held on May 20, 2014 at the University of Massachusetts Medical School, Worcester, Mass.Rights
Copyright the Author(s)Distribution License
http://creativecommons.org/licenses/by-nc-sa/3.0/ae974a485f413a2113503eed53cd6c53
10.13028/3af7-sy32