Diagnosis and treatment of patients with recurrent gastroduodenal bleeding - Shaprynskyi V.O. 2009

Clinical characteristics of syndromes associated with acute gastrointestinal bleeding
Assessment of comorbidities in patients with gastrointestinal bleeding

The impact of comorbidities on the recurrence of bleeding is difficult to assess definitively, as the same pathology varies in severity among different patients. Its impact on the overall systemic condition of these patients is also inconsistent. Many patients present with multiple comorbidities, which further exacerbates the condition of patients with ulcer-induced gastrointestinal bleeding. Therefore, depending on the presence of comorbidities, it is advisable to classify all patients into 4 groups (Shaprynskyi V.O., Pavlyk I.V., 2007):

1) patients with no comorbidities or with minor comorbidities (ECG changes without clinical signs of disease);

2) patients with moderate comorbidities (Hypertension, chronic obstructive pulmonary disease manageable with medical therapy, compensated Diabetes Mellitus, stage 1 Heart Failure, stage 1 respiratory failure, etc.)

3) patients with severe compensated comorbidities (heart and lung diseases that limit physical activity, compensated diabetes mellitus with complications, compensated Liver cirrhosis, stage 1 chronic renal failure.

4) patients with severe decompensated comorbidities (severe heart failure, severe respiratory failure, severe renal and hepatic impairment, decompensated diabetes mellitus, etc.)