Hematemesis is associated with worse outcomes in upper gastrointestinal bleeding: a retrospective study

Martins, Gabriela Caetano LopesRodrigues, Carolina Villalba MoyaRibeiro, Lucas DomingosPosegger, Karin RomanoPacheco, Rafael Leitedel Grande, Leonardo de MelloAdão, Diego

ABSTRACT Purpose: To evaluate whether hematemesis is associated with increased morbidity and mortality for upper gastrointestinal bleeding. Methods: A retrospective cohort study was conducted at a quaternary university hospital from January 2022 to September 2024. Adults presenting with upper gastrointestinal bleeding, confirmed by endoscopy, were included. We excluded patients with terminal disease, patients who refused to receive blood products, and trauma. The main outcomes were all-cause mortality, need for orotracheal intubation, emergency blood transfusion, need for re-endoscopy, and length of hospital and intensive care unit (ICU) stays. Results: A total of 69 patients (65% male, mean age 58 years) were included. Hematemesis was associated with a higher need for emergency blood transfusions (73% vs. 23%; odds ratio - OR = 8.82, 95% confidence interval - 95%CI 2.44-31.94, p = 0.001), longer hospital (12 vs. 6 days; mean difference - MD = 6.02, 95%CI 2.39-9.64, p = 0.001) and ICU stays (7.7 vs. 3.2 days; MD = 4.5, 95%CI 1.73-7.26, p = 0.002). Data were sparse and imprecise on all-cause mortality, orotracheal intubation, and the need for re-endoscopy. Conclusion: Hematemesis is associated with higher transfusion requirements and longer hospital and ICU stays. These findings highlight the potential predictive value of hematemesis in acute upper gastrointestinal bleeding.