Blood is hypercoagulable following GI haemorrhage [1], and vascular thrombosis has been reported to be the main cause of death [2]. To study the relationship between coagulation and clinical outcome, Impedance Clotting Time (ICT) wac measured daily using the Biobridge [1] and clinical outcome prospectively recorded in 125 patients with acute severe GI haemorrhage.Mean (±se mean) ICT on admission was markedly shortened at 4.8±0.2 mins (normal range 8-12 mins) (p<0.001, t-Cest). Sixty patients received blood transfusion within 24 hours resulting in significantly prolonged ICT of 6.2±0.4 mins compared to 4.0±0.3 mins in the 56 not transfused (p<0.01). In 23 patients who rebled, the ICT at 24 hours of 6.7±0.4 mins demonstrated reduced hypercoagulability. Twenty of these 23 patients had bee:: transfused prior to rebleeding, a significantly greater proportion than in those who did not rebleed (p<0.00l). Six patients died, 3 of myocardial infarction, 1 of stroke, and 2 of continued haemorrhage. Mean ICT in the 4 patients dying from thrombotic vascular disease was 2.3±0.1 mins although 2 had also rebled.Clinical outcome in GI haemorrhage is strongly related to coagulation changes. The main cause of death was thrombotic vascular disease.1. Blair SD, Janvrin SB, McCollum CN, Greenhalgh RM. The effect of early blood transfusion on gastrointectinal
haemorrhage. Br J Surg 1986; 73: 792-4.2. Allan R, Dykes P. A study of the factors influencing mortality rates fron gastrointestinal haenorrhage. Quart JMed 1976; 180: 533-50.
Clinical outcome of patients with recurrent or refractory localized Ewing's sarcoma family of tumors: A retrospective report from the Japan Ewing Sarcoma Study Group