An epidemiological study of acute upper gastrointestinal bleeding in Crete, Greece

Objectives Information about the epidemiology of acute upper gastrointestin al bleeding (UGIB) in southern Europe is very limited and especially in Gre ece non-existent. Our study sought to determine the current epidemiology of acute UGIB (incidence, mortality and case fatality) in the prefecture of H eraklion-Crete. Design/methods From February 1998 to February 1999, we prospectively obtain ed data on all patients with acute UGIB in the prefecture of Heraklion-Cret e. All patients who were permanent residents of the prefecture of Heraklion , aged 16 years and over with acute UGIB were included in the study. Results During this period, 353 cases of acute UGIB were included in the st udy. The overall incidence of acute UGIB is 160/100 000 adults per year wit h a male-to-female ratio of 1.7 and a mean age 66.2 +/- 17.1 years, The inc idence rises from 30 in those aged under 30 years to 609 in those aged over 75 years. The overall population mortality was 9/100 000 adults per year. Overall case fatality during hospitalization was 5.6%. All deaths occurred in patients older than 60 years. One or more comorbid illnesses were noted in 61% of cases. Recent intake of non-steroidal antiinflammatory drugs (NSA IDs) was reported in 49% of the cases. The most common recorded diagnoses w ere erosive disease in 108(30.5%) patients, duodenal ulcer in 97 (27.4%) an d gastric ulcer in 75 (21.2%). Rebleeding occurred in 41 patients (12%), Tw elve patients (3.3%) had surgery during hospitalization. Conclusions The overall annual incidence of acute UGIB in the prefecture of Heraklion-Crete is one of the highest reported in Europe and increases app reciably with age. Both population mortality and case fatality are slightly lower compared to those reported in most previous studies. (C) 2000 Lippin cott Williams & Wilkins.