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Haematemesis and melaena: a clinical study of 251 hospital admissions.

The consecutive admissions to hospital of 251 patients for hœmatemesis, melœna or both are documented. Duodenal ulcer was the most frequent diagnosis. Recent salicylate ingestion was found in 87% of patients, and 41% said that they took two or more tablets each day. The overall fatality rate was 11.6%, while it was 7.9% in the combined gastric and duodenal ulcer group. There were more deaths amongst those patients who on admission had a hœmoglobin level of less than 8 gm/100 ml, a blood pressure of less than 100 mm Hg, or a pulse rate greater than 100 per minute, or a combination of these; also amongst those aged over 60 years. The average age of the whole group was 59 years, and the average age of those dying was 72. Hœmorrhage was the major cause of death in 50%. Surgery was performed in 16% of patients, with Polya gastrectomy the most frequent operation.