ArticleThe American journal of gastroenterology2018
Severity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis.
Article in The American journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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18 citing papers in PubMed, 33 citations in OpenAlex.
- Predictors and therapeutic yield of oesophagogastroduodenoscopy in critically and morbidly ill patients presenting with coffee-ground vomitus.Surgical endoscopy · 2026Article
- Red cell distribution width-to-albumin ratio predicts mortality in critically ill patients with gastrointestinal bleeding: A retrospective cohort study with external validation.The Journal of international medical research · 2026Article
- Development and internal validation of a machine learning-based model to predict 1-year all-cause mortality in patients with gastrointestinal bleeding with type 2 diabetes.BMC medical informatics and decision making · 2026Article
- Identifying Low-Risk Patients with Cirrhosis and Acute Gastrointestinal Bleeding That May Not Require Urgent Endoscopy.Advances in therapy · 2026Article
- Association between duration of alcohol consumption and risk of hematemesis in patients with alcoholic cirrhosis complicated by esophagogastric variceal bleeding: a case-control study.BMC gastroenterology · 2025Article
- Machine learning based CAGIB score predicts in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.NPJ digital medicine · 2025Article
- Comparison of Prophylactic Transcatheter Arterial Embolization and Standard Therapy in High-Risk Non-Variceal Upper Gastrointestinal Bleeding: A Meta-Analysis.Gastroenterology research · 2025Article
- Etiology and Short-Term Outcomes of Upper Gastrointestinal Bleeding in Patients Presenting at the Emergency Department in a Tertiary Hospital in a Low Resource Setting-A Prospective Cohort Study.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Defining and Evaluating the Impact of Bleeding Severity on Time to Endoscopy and Mortality Risk: A Prospective Multicenter Cohort Study.Journal of clinical medicine · 2025Article
- Prospective Analysis of Critically Ill Patients with Gastrointestinal Bleeding: An Observational Study.Journal of clinical practice and research · 2025Article
- Hematemesis is associated with worse outcomes in upper gastrointestinal bleeding: a retrospective study.Acta cirurgica brasileira · 2025Article
- Factors associated with severity and length of hospital stay in patients with acute upper gastrointestinal bleeding: insights from two Ethiopian hospitals.International journal of emergency medicine · 2024Article
- Timing of endoscopy in cirrhotic patients with acute variceal bleeding: protocol of a multicenter randomized controlled trial.Therapeutic advances in gastroenterology · 2024Article
- A Nomogram Model for Prediction of Mortality Risk of Patients with Dangerous Upper Gastrointestinal Bleeding: A Two-center Retrospective Study.Current medical science · 2023Article
- Comparison of intermittent and continuous proton pump inhibitor infusions in patients with non-variceal upper gastrointestinal bleeding at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A retrospective study.Saudi medical journal · 2022Article
- Practice guidance for the use of terlipressin for liver cirrhosis-related complications.Therapeutic advances in gastroenterology · 2022Article
- British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding.Frontline gastroenterology · 2020Article
- External validation of Liaoning score for predicting esophageal varices in liver cirrhosis: a Chinese multicenter cross-sectional study.Annals of translational medicine · 2019Article
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Authors and funding
7 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesNumerous reviews indicate bloody hematemesis signifies more severe bleeding than coffee-grounds hematemesis. We assessed severity and outcomes related to bleeding symptoms in a prospective study.
methodsConsecutive patients presenting with hematemesis or melena were categorized as bloody emesis (N=1209), coffee-grounds emesis without bloody emesis (N=701), or melena without hematemesis (N=1069). We assessed bleeding severity (pulse, blood pressure) and predictors of outcome (hemoglobin, risk stratification scores) at presentation, and outcomes of bleeding episodes. The primary outcome was a composite of transfusion, intervention, or mortality.
resultsBloody and coffee-grounds emesis were similar in pulse ≥100 beats/min (35 vs. 37%), systolic blood pressure ≤100 mm Hg (12 vs. 12%), and hemoglobin ≤100 g/l (25 vs. 27%). Risk stratification scores were lower with bloody emesis. The composite end point was 34.7 vs. 38.2% for bloody vs. coffee-grounds emesis; mortality was 6.6 vs. 9.3%. Hemostatic intervention was more common (19.4 vs. 14.4%) with bloody emesis (due to a higher frequency of varices necessitating endoscopic therapy), as was rebleeding (7.8 vs. 4.5%). Outcomes were worse with hematemesis plus melena vs. isolated hematemesis for bloody (composite: 62.4 vs. 25.6%; hemostatic intervention: 36.5 vs. 13.8%) and coffee-grounds emesis (composite: 59.1 vs. 27.1%; hemostatic intervention: 26.4 vs. 8.1%).
conclusionsBloody emesis is not associated with more severe bleeding episodes at presentation or higher mortality than coffee-grounds emesis, but is associated with modestly higher rates of hemostatic intervention and rebleeding. Outcomes with hematemesis are worsened with concurrent melena. The presence of bloody emesis plus melena potentially could be considered in decisions regarding timing of endoscopy.
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