ABO blood groups in gastric bleeding.

EDITORIAL SYNOPSIS This paper confirms previous studies showing the increased risk of bleeding associated with blood group 0. There is an indication that this may also be true for acute perforation and indeed the relationship may be with the severity of the ulcer disease. In a previous paper (Horwich and Evans, 1966) a relationship was shown between the loss of gastric mucosal cells in 160 volunteer subjects and their ABO blood groups and ABH secretor status. Aspirin enhanced the loss from the gastric mucosa, and it was postulated that clinical overt bleeding from the gastric mucosa, whether aspirin-induced or not, may also be related to the ABO blood groups and secretor status. The present investigation concerns this problem, and it was also thought to be of value to extend the investigation to include subjects with duodenal ulcer because of the reported association with blood group 0 reported an increased frequency of group 0 in gastric and duodenal ulcer subjects who had bled and an increased incidence of non-secretors in those who had undergone operation. METHODS Two separate series of patients were ascertained. SUBJECTS WITH HAEMATEMESIS AND MELAENA The first series was ascertained by collecting the case records of patients who had been admitted to six hospitals in the Liverpool area with haematemesis and melaena. To obtain a large series of in-patients a list of case records was prepared by examining hospital and ward admission registers and the diagnostic indices for haematemesis and melaena. The case sheets were scrutinized for evidence of bleeding and were included in the series only if the following criteria were satisfied:-Substantial haematemesis or frank melaena witnessed by a member of the hospital medical staff or senior nursing staff; history of haemate-mesis or melaena together with a very low or falling haemoglobin level and strongly positive faecal occult blood test; acute clinical 'shock', requiring blood transfusion and strongly positive occult blood test. Case records were examined for a history of salicylate ingestion during the 48 hours before the onset of bleeding and recorded at the time of admission. Details were abstracted of a barium meal examination carried out within two weeks after the bleeding episode. Where the radiologist gave a firm opinion on the presence or absence of a gastric or duodenal lesion, this diagnosis was accepted for the purpose of this investigation. Persistent duo-denal deformity was accepted as being due to scarring-from ulceration. Gastric ulcers have …