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The presenting symptoms of upper gastrointestinal bleeding may predict clinical outcomes. Investigators in six countries prospectively assessed outcomes among 3000 patients with upper gastrointestinal bleeding — 1200 with bloody hematemesis (BH), 700 with coffee-grounds (CG) hematemesis, and nearly 1100 with melena alone. Some patients with BH or CG also had melena. Results were as follows:
Compared with the hematemesis groups, patients with melena alone had a lower mean heart rate, higher incidence of tachycardia, and at least a doubled increased prevalence of low hemoglobin (at both ≤100 g/L and ≤80 g/L).
The mean scores of risk stratification tools (Glasgow-Blatchford, Rockall, and AIMS65) were all lower in the BH group than in the CG grou…