Postoperative acute gastrointestinal tract hemorrhage and multiple-organ failure.

Acute upper gastrointestinal tract hemorrhage (AUGH) was evaluated postoperatively in 720 critically ill patients and correlated with multiple-organ failure (MOF). The AUGH incidence was 20.1%. Patients were divided into three groups. Group 1 (n = 77) patients were admitted without AUGH, but developed MOF and later AUGH, with renal failure as the most common previous failure. Group 2 (n = 36) patients were admitted with AUGH and other failures. Group 3 (n = 32) patients were admitted without AUGH, which appeared as the first or only failure. Means +/- SDs for MOF and mortality for groups 1, 2, and 3, respectively, were as follows: 3.2 +/- 0.8, 75.3%; 3.2 +/- 1.1, 63.9%; and 1.8 +/- 0.8, 28.1%. A control group (n = 90) with MOF but without AUGH presented 1.8 +/- 0.9 for MOF and 41.1% mortality. Mortality, sepsis, and mean MOF were higher in AUGH cases and lower in group 3 vs groups 1 and 2. Acute upper gastrointestinal tract hemorrhage is a component of MOF (Baue's syndrome) that is closely related to sepsis particularly after abdominal surgery.