Acute Upper Gastrointestinal Bleeding in Adult Patients at Colonial War Memorial Hospital

Upper gastrointestinal (GI) bleeding is defined as any gastrointestinal bleeding that is proximal to the ligament of Treitz (l) It is a major, potentially life-threatening condition that results in about 250,000 to 300,000 admissions and about 30,000 deaths in the United States every year. No such data of estimates of the burden of illness exists in the local setting. An average of about 218 cases are admitted to all hospitals in Fiji combined, on a yearly basis, according to National Health statistics but this data is crude and the rate of death, and the frequency of the various causes of Upper GI bleeding has not been defined.
Fiji is a developing nation in the South Pacific with a total population of roughly 880,000 and like most developing nations, there is paucity of credible data on disease states in Fiji, which to a significant degree hinders service planning and appropriate allocation of scarce resources (3 ) This holds true for gastrointestinal disorders as there is lack of even basic information on incidence and prevalence or even survival of patients with GI bleeding in the Fijian population.
The Fijian health system is in a state of transition with tertiary health services gearing towards providing some degree of subspecialty care. This is evident with the recent set up of the World Gastroenterology Organization training center for the Pacific at the Colonial War Memorial (CWM) Hospital in Suva to cater for gastroenterology services in this area, and training needs in the Pacific. At present it is expected to service an estimate total population of about a quarter million roughly based on the catchment area of CWMH.
Hospital.
Judicious planning of service delivery is mandatory especially in resource limited settings such as ours to ensure emphasis on priority health areas. It is essential therefore to have information about various disease states and condition to allow for suitable distribution of the limited resources. Gastrointestinal bleeding is recognized as a problem in Fiji, but the extent and nature of the problem is unknown. This study therefore aims to describe the types and extent of upper gastrointestinal bleeding and thus help facilitate towards the organization of appropriate Gastroenterology services locally.