The clinical pattern and factors that influence the short term outcome of upper gastrointestinal bleeding at Kenyatta National Hospital

Abstract

A prospective study is reported of 97 consecutive patients admitted to the Kenyatta National Hospital due to upper gastrointestinal haemorrhage. A positive endoscopic diagnosis was made in 90 (93%) cases. Three major causes of bleeding were found to be oesophageal varices in 34 (35%) patients, duodenal ulceration in 17 (17.5%) patients and superficial inflammatory lesions in 17 (17.5%) patients. Seventeen (17.5%) patients had multiple lesions with superficial inflammatory lesions and oesophageal varices as the commonest combination. In 86 (88%) patients bleeding settled on simple conservative measures which included intravenous fluids, blood transfusion and antacids. Further haemorrhage was observed in 11 (11.3%) patients. In this study tachycardia (>100jminute), hypotension (systolic BP < 100 mmHg) and low haemoglobin «8 gjdl) at admission were all correlated with a poor outcome. Bleeding varices bleeding had the worst prognosis and the overall mortality rate was 5%.