Upper gastrointestinal bleeding epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

About 75% of patients presenting to the emergency room with GI bleeding have an upper source. The diagnosis is easier when the patient has hematemesis. In the absence of hematemesis, 40% to 50% of patients in the emergency room with GI bleeding have an upper source. Determining whether a patient truly has an upper GI bleed versus lower gastrointestinal bleeding is difficult. Whiting studied a cohort of 325 patients and found the odds ratios for the strongest predictors were: black stool, 16.6 (95% confidence interval [CI], 7.7-35.7); age < 50 years, 8.4 (95% CI, 3.2-22.1); and blood urea nitrogen/creatinine ratio 30 or more, 10.0 (95% CI, 4.0-25.6) . Seven (5%) of 151 with none of these factors had an upper GI tract bleed, versus 63 (93%) of 68 with 2 or 3 factors. Ernst found similar results.

Epidemiology

Incidence

• The incidence of acute UGIB is approximately 50 to 100 per 100,000 individuals worldwide.
• Approximately 100,000 patients are admitted to US hospitals for therapy for UGIB.

Demographics

Age

• Patients of all age groups may develop upper gastrointestinal bleeding.
• The population with UGIB has become progressively older, with a concurrent increase in significant comorbidities that increase mortality.
• Mortality increases with older age (>60 y), in both males and females.

Race

There is no racial predilection to upper gastrointestinal bleeding.

Gender

Males are more commonly affected by UGIB than females. The males to female ratio is approximately 2 to 1.

References

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