Ae. Henriksson et al., BLEEDING-TIME AND CONCENTRATIONS OF VON-WILLEBRAND-FACTOR IN PATIENTSWITH ACUTE UPPER GASTROINTESTINAL-BLEEDING, The European journal of surgery, 162(8), 1996, pp. 627-631
Objective: To evaluate the prevalence of impaired primary haemostasis
in patients with acute upper gastrointestinal bleeding. Design: Prospe
ctive open study. Setting: County hospital, Sweden. Subjects: 160 cons
ecutive patients admitted with haematemesis or melaena, or both. Inter
ventions: Diagnosis verified on admission by endoscopy. Consumption of
non-steroidal anti-inflammatory drugs (NSAID), transfusion requiremen
ts, presence of chronic liver disease, and age were recorded. Main out
come measures: Skin bleeding time was measured on admission with a mod
ified Ivy method using the Simplate II bleeding time device; von Wille
brand factor and routine haematological tests were analysed. Results:
In 31 of the patients (19%) the skin bleeding time was prolonged (over
10 minutes), and these patients also had a significantly lower packed
cell volume on admission. In all patients the concentration of von Wi
llebrand factor was increased which might explain why there was no sig
nificant difference in bleeding time between those who did and those w
ho did not take NSAIDs. Conclusion: We recommend measurement of bleedi
ng time in patients who present with haematemesis or melaena, or both,
to detect those with impaired primary haemostasis.