LOW INCIDENCE OF HEMODYNAMIC INSTABILITY IN PATIENTS WITH GASTROINTESTINAL HEMORRHAGE

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.