Rebleeding rate and the need for blood transfusion in patients with upper gastrointestinal tumor bleeding are higher than in patients with peptic ulcer bleeding

Introduction: The aim of this study was to compare peptic ulcer bleeding (PUB) with upper gastrointestinal tumor bleeding (UGITB) while placing special emphasis on the incidence, outcomes including thirty-day re-bleeding rate, mortality and the need for blood transfusion. Aims & Methods: A total of 2198 patients referred to our Emergency Department with upper gastrointestinal bleeding (UGIB) were included in this prospective study during 5 years (from January 2008 till December 2012) ; 796 with PUB and 61 with UGITB, found during urgent upper GI endoscopy performed within 24 hours of admission. Results: Cumulative incidence of UGIB was 126/100000 in a 5-year period. 796(36.2%) patients had PUB and 61 (2.8%) patients had UGITB. UGITB was most often found in the stomach (58/95%) ; the tumors were dominantly malignant (55/90%), most of them adenocarcinoma (48/87.3%). Median age for PUB was 67, and for UGITB 76 years(p50.01). PUB and UGITB were more common in men (62.3% and 52.5%). Re-bleeding occurred more often in patients with UGITB(19.7% vs 9.7%, p50.01), but a higher number of patients with PUB required surgical intervention due to uncontrolled bleeding (5.9% vs 3.3% p50.01). Thirty-day mortality showed no difference between the two groups (5.2% vs 7.2%). Transfusion of red blood cells was administered more often in patients with UGITB (75.4% vs 49.5%, p50.01), while patients with PUB received comparably higher volumes of transfused red blood cells. Conclusion: Patients with UGITB have higher re-bleeding rates, require surgical intervention less often, and are more often treated with blood transfusion than PUB.