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Postoperative Acute Gastrointestinal Tract Hemorrhage and Multiple-Organ Failure

Eduardo Bumaschny, MD; Guillermo Doglio, MD; Jorge Pusajó, MD; Liliana Vetere, MD; Carlos Parra, MD; Ricardo M. Grosso, MD; Eduardo Schieppati, MD
Arch Surg. 1988;123(6):722-726. doi:10.1001/archsurg.1988.01400300068011.
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• Acute upper gastrointestinal tract hemorrhage (AUGH) was evaluated postoperatively in 720 critically ill patients and correlated with multiple-organ failure (MOF). The AUGH incidence was 20.1%. Patients were divided into three groups. Group 1 (n = 77) patients were admitted without AUGH, but developed MOF and later AUGH, with renal failure as the most common previous failure. Group 2 (n = 36) patients were admitted with AUGH and other failures. Group 3 (n = 32) patients were admitted without AUGH, which appeared as the first or only failure. Means ± SDs for MOF and mortality for groups 1, 2, and 3, respectively, were as follows: 3.2 ± 0.8, 75.3%; 3.2 ± 1.1, 63.9%; and 1.8 ± 0.8, 28.1%. A control group (n = 90) with MOF but without AUGH presented 1.8 ± 0.9 for MOF and 41.1% mortality. Mortality, sepsis, and mean MOF were higher in AUGH cases and lower in group 3 vs groups 1 and 2. Acute upper gastrointestinal tract hemorrhage is a component of MOF (Baue's syndrome) that is closely related to sepsis particularly after abdominal surgery.

(Arch Surg 1988;123:722-726)


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