OMGE international upper gastrointestinal bleeding survey, 1978-1986.

This presentation describes a further survey conducted under the auspices of the OMGE Research Committee: an international survey of over 4000 patients presenting to 205 clinicians in 44 centres in 21 countries. This multinational survey has been the first in this area of medicine to use specifically designed proformata and pre-agreed definitions of terminology, alongside automated data analysis. A total of 4506 patients' data were forwarded from 44 centres, the vast majority (4431; 98.3%) containing acceptable data fro subsequent analysis. The commonest cause of bleeding was peptic ulceration (36.7% of the total group), followed by oesophageal varices (13.3%) and gastric erosions (6.7%). Over 600 cases exhibited dual pathology. As regards outcome, in 1137 patients bleeding failed to settle (25.5%), whilst 409 patients died (9.2% of the total group, and 36.0% of those whose bleeding failed to settle). Detailed computer-aided studies show it is currently impossible to determine the source of bleeding without recourse to high technology such as radiologic or endoscopic intervention. If identification of the source of the bleeding is desirable clinically, then these high-technology investigations must be employed. As regard prognosis, a computer program has enabled categorisation of patients into risk categories as regards further or continued bleeding or death. This program has been tested on 2623 patients with considerable accuracy. In the computer's 'high-risk' category, 60% of patients re-bled, and 32% died. Conversely in the 'very low' risk category, only 4% re-bled, and no patient died. These findings have enabled the construction of a simple prognostic system for use in remote areas.(ABSTRACT TRUNCATED AT 250 WORDS)