Objectives Patients who develop upper gastrointestinal bleeding (UGIB) while in hospital appear to have a poor prognosis. Our study aims at analysing the difference in outcome between in‐patients (IPs) and out‐patients presenting with variceal and non‐variceal UGIB. Methods We conducted a multicentre prospective study by collecting data about variceal and non‐variceal UGIB cases through 46 hospitals in France between November 2017 and October 2018. We then compared baseline demographic features, endoscopic findings and outcome between patients who developed variceal and non‐variceal UGIB on admission (OPs) and those at least 24 h after hospitalisation (IPs). Our primary end‐point was mortality and re‐bleeding rates at 6 weeks of bleeding onset. Results A total of 2498 UGIB cases were identified, of whom 634 (25.4%) occurred in IPs. IPs were older than OPs (72.5 vs. 67.2 years old, p 5 present in 40.9% (vs. 30.3% in OPs, p 11 (p = 0.017, 0.011 and 0.008, respectively). Conclusion IPs who develop variceal and non‐variceal UGIB are more likely to be elderly with more comorbidities. They have a higher rate of mortality and rebleeding. Independent predictors of mortality were underlying coagulopathy and bleeding recurrence. An optimal bleeding management and efficient rebleeding prevention may improve outcome in these patients.
Key Point Summarize the established knowledge on this subject Upper gastrointestinal bleeding (UGIB) in already hospitalised patients (IPs) appears to have a worse prognosis when compared to UGIB in out‐patients (OPs).Few studies have addressed this issue, most of which are retrospective. They found a poor short‐term outcome in IPs without being able to identify modifiable risk factors that could affect the prognosis. Significant and/or new findings of this study? We demonstrated in this prospective and multicentre study a greater 6‐week mortality and rebleeding rates in IPs versus OPs.IPs were older and had a higher rate of comorbidities. Prothrombin time