Risks of surgery for upper gastrointestinal hemorrhage: 1972 versus 1982.

A retrospective comparison was undertaken to determine if the risks of undergoing surgery for nonvariceal upper gastrointestinal hemorrhage had changed between 1972 and 1982. In 1982, patients were on the average 9 years older, there was a significant decrease in bleeding from duodenal ulcers compared with 1972 data, gastric ulcer rates remained unchanged, and diffuse gastritis occurred more frequently in 1982. Mortality and morbidity rates showed no significant differences; however, the patient population did change with the emergence of older patients, in whom bleeding developed after hospitalization for other reasons. These patients comprised 30 percent of the 1982 study population. If further improvements in surgical treatment of upper gastrointestinal hemorrhage are to occur, these patients must be identified and aggressively managed.