Patients with gastrointestinal hemorrhage are frequently admitted to c
ritical care units, in large part to be observed for signs of hemodyna
mic instability. All patients admitted with gastrointestinal bleeding
to our medical intensive care unit over a 1-year period (n = 108) were
retrospectively reviewed to determine the incidence of hemodynamic in
stability. In an elderly patient population with predominantly nonvari
ceal bleeding, only 13%:, of those admitted had documented hypotension
that led to an intervention. Only 7% had clinically significant hypot
ension after the first 5 hours of admission. Admission clinical criter
ia were analyzed by multivariate analysis but could not reliably predi
ct patients at increased risk for hemodynamic instability. However, pa
tients without significant comorbid illness who have been endoscopical
ly shown to have a low-risk lesion can be considered for early transfe
r to a regular bed after a short period of close observation. This cou
ld lead to better resource utilization and cost savings without jeopar
dizing patient care.