Acute on chronic gastrointestinal bleeding: a unique clinical entity

Gastrointestinal bleeding is defined in temporal–spatial terms—as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined ‘acute on chronic’ gastrointestinal bleeding. We prospectively identified all patients who under...

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Bibliographic Details
Published in:Journal of investigative medicine 2017-06, Vol.65 (5), p.892-898
Main Authors: Rockey, Don C, Hafemeister, Adam C, Reisch, Joan S
Format: Article
Language:English
Subjects:
Academic Medical Centers
Adult
Aged
Anemia, Iron-Deficiency
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Anticoagulants - therapeutic use
Colon - pathology
Endoscopy, Gastrointestinal
Esophagus - pathology
Female
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Tract - pathology
Humans
Male
Middle Aged
Multivariate Analysis
Platelet Aggregation Inhibitors - therapeutic use
Prospective Studies
Rectum - pathology
Stomach - pathology
Treatment Outcome
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Summary:Gastrointestinal bleeding is defined in temporal–spatial terms—as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined ‘acute on chronic’ gastrointestinal bleeding. We prospectively identified all patients who underwent endoscopic evaluation for any form of gastrointestinal bleeding at a University Hospital. Acute on chronic bleeding was defined as the presence of new symptoms or signs of acute bleeding in the setting of chronic bleeding, documented as iron deficiency anemia. Bleeding lesions were categorized using previously established criteria. We identified a total of 776, 254, and 430 patients with acute, chronic, or acute on chronic bleeding, respectively. In patients with acute on chronic gastrointestinal bleeding, lesions were most commonly identified in esophagus (28%), colon and rectum (27%), and stomach (21%) (p
ISSN:1081-5589
1708-8267
DOI:10.1136/jim-2017-000431