Acute upper gastrointestinal bleeding: a clinical review

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is one of the most common medical emergencies, with around 85 000 cases per year in the UK, and carries a 10% hospital mortality rate. Despite significant improvements in treatments, this mortality rate has not improved significantly in the past 50 years. Deaths are rarely directly associated with exsanguination but are related to poorly tolerated blood loss and resultant shock, aspiration and complications of therapeutic procedures. As such, mortality from AUGIB is strongly associated with advanced age and presence of severe comorbidity. This clinical review will define what AUGIB is and discuss its treatment and management. In addition, it will consider and critique the available scoring systems used for risk stratification of this condition, as well as offer insight into the research underpinning the relevant guidelines and service provision across the NHS.