Upper gastrointestinal bleeding seen from 1988 by 1999 involved 1, 271 examples, 237 (18.6%) of which were complicated by severe basal disease. Of the 237, 79 were gastric ulcers, 52 juodenal ulcers, 42 esophageal hemorrhages, 39 acute gastrie mucosal lesion (AGML), and 16 anastomotic hemorrhages. Basal disease included 57 marignant tumors, 50 single-organ disorders, 34 cerebrovascular disorders, and 36 flame and ulcers within esophageal hemorrhage. A gastric tube was required in 25 patients. Hemorrhaging from the thoracic aorta wasseen in 5 patients, anyway died. Eight patients had undergone surgery for cancer of the pancreas, gallbladder, or liver and 16 suffered anastomotic hemorrhaging. An anticoagulant was used in 18 of 26 patients with ischemic heart disease and cerebral infarction. In endoscope hemostasis 1 month were 43 (18.1%) died. In 5 of 43 patients with, gastrointestinal bleeding led directly to death within 43 examples.
Postoperative course, perioperative management, and general condition at discharge were studied in 49 patients aged-64 years who underwent abdominal emergency surgery. They were divided into 2 groups- 14 with heart disease (HD) and 35 without. The male/female ratio tended to be higher in those with HD. Although no significant difference was seen in the APACHE-II score between groups before surgery (13.3 vs. 11.8), the duration of assisted respiration (17.2 vs. 9.1 days) and duration of circulatory management (14. 9 vs. 9.4 days) were longer in those with HD. Mortality was higher in those with HD, although not significantly so (35.7% vs. 20.0%). Compared with those without HD, mean hospital days were more (26.1 vs. 20.8 days) and improvement in the Barthel index for ADL (43.5 vs. 50.3) and ps (3 vs. 2) was delayed. Patients with HD were referred to other hospitals or institutions rather than returning home more frequently than those without (44% vs. 25%). After abdominal emergency surgery, care must be taken to prevent deterioration in HD and associated respiratory disease, and in infection in those with heart disease. Prolonged hospitalization and poor general condition are associated with poor prognosis.