Factors predisposing to recurrent haemorrhage after acute gastrointestinal bleeding.

A retrospective survey of 472 consecutive hospital admissions for acute upper gastrointestinal bleeding showed that patients with a large initial bleed are more likely to bleed again than those with a small initial bleed. The incidence of recurrent haemorrhage is also related to the interval since the last bleeding episode, so that patients showing no clinical evidence of haemorrhage for 48 hours are unlikely to bleed again in the near future. Patients admitted after a haematemesis have a higher incidence of recurrent haemorrhage than those admitted after melaena only. Aetiology has been confirmed as an additional important factor, the incidence being highest in those with oesophageal varices or a chronic gastric ulcer. Contrary to widespread belief, age does not appear to affect the incidence of recurrent haemorrhage, nor do other constitutional factors such as sex or the ABO blood group.