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Predictive factors of mortality within 30 days in patients with nonvariceal upper gastrointestinal bleeding

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초록

Background/Aims: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency that can be life threatening. This study evaluated predictive factors of 30-day mortality in patients with this condition. Methods: A prospective observational study was conducted at a single hospital between April 2010 and November 2012, and 336 patients with symptoms and signs of gastrointestinal bleeding were consecutively enrolled. Clinical characteristics and endoscopic findings were reviewed to identify potential factors associated with 30-day mortality. Results: Overall, 184 patients were included in the study (men, 79.3%; mean age, 59.81 years), and 16 patients died within 30 days (8.7%). Multivariate analyses revealed that comorbidity of diabetes mellitus (DM) or metastatic malignancy, age ≥ 65 years, and hypotension (systolic pressure < 90 mmHg) during hospitalization were significant predictive factors of 30-day mortality. Conclusions: Comorbidity of DM or metastatic malignancy, age ≥ 65 years, and hemodynamic instability during hospitalization were predictors of 30-day mortality in patients with NVUGIB. These results will help guide the management of patients with this condition.

Abstract

Background/Aims: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency that can be life threatening. This study evaluated predictive factors of 30-day mortality in patients with this condition. Methods: A prospective observational study was conducted at a single hospital between April 2010 and November 2012, and 336 patients with symptoms and signs of gastrointestinal bleeding were consecutively enrolled. Clinical characteristics and endoscopic findings were reviewed to identify potential factors associated with 30-day mortality. Results: Overall, 184 patients were included in the study (men, 79.3%; mean age, 59.81 years), and 16 patients died within 30 days (8.7%). Multivariate analyses revealed that comorbidity of diabetes mellitus (DM) or metastatic malignancy, age ≥ 65 years, and hypotension (systolic pressure < 90 mmHg) during hospitalization were significant predictive factors of 30-day mortality. Conclusions: Comorbidity of DM or metastatic malignancy, age ≥ 65 years, and hemodynamic instability during hospitalization were predictors of 30-day mortality in patients with NVUGIB. These results will help guide the management of patients with this condition.

참고문헌 (28)

  1. Marmo R, "Predictive factors of mortality from nonvariceal upper gastrointestinal hemorrhage: a multicenter study", Am J Gastroenterol, 103, pp.1639~1647 (2008)
  2. Holster IL, "Management of acute nonvariceal upper gastrointestinal bleeding: current policies and future perspectives", World J Gastroenterol, 18, pp.1202~1207 (2012)
  3. Gonzalez-Gonzalez JA, "Predictors of in-hospital mortality in patients with non-variceal upper gastrointestinal bleeding", Rev Esp Enferm Dig, 103, pp.196~203 (2011)
  4. Barkun AN, "International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding", Ann Intern Med, 152, pp.101~113 (2010)
  5. Saltzman JR, "A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding", Gastrointest Endosc, 74, pp.1215~1224 (2011)
  6. Rockall TA, "Risk assessment after acute upper gastrointestinal haemorrhage", Gut, 38, pp.316~321 (1996)
  7. Blatchford O, "A risk score to predict need for treatment for upper-gastrointestinal haemorrhage", Lancet, 356, pp.1318~1321 (2000)
  8. Romagnuolo J, "Simple clinical predictors may obviate urgent endoscopy in selected patients with nonvariceal upper gastrointestinal tract bleeding", Arch Intern Med, 167, pp.265~270 (2007)
  9. Wiley TE, "Impact of alcohol on the histological and clinical progression of hepatitis C infection", Hepatology, 28, pp.805~809 (1998)
  10. Marin-Gabriel JC, "Noninvasive assessment of liver fibrosis: serum markers and transient elastography (FibroScan)", Rev Esp Enferm Dig, 101, pp.787~799 (2009)
  11. "The 86th Congress of the Japanese Society of Legal Medicine. Okayama, Japan. April 17-19, 2002. Abstracts", Nihon Hoigaku Zasshi, 56, pp.1~203 (2002)
  12. Jeon SW, "Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions", Surg Endosc, 23, pp.1974~1979 (2009)
  13. Forrest JA, "Endoscopy in gastrointestinal bleeding", Lancet, 2, pp.394~397 (1974)
  14. Xu HW, "The effects of cefazolin on cirrhotic patients with acute variceal hemorrhage after endoscopic interventions", Surg Endosc, 25, pp.2911~2918 (2011)
  15. Mungan Z, "An observational European study on clinical outcomes associated with current management strategies for non-variceal upper gastrointestinal bleeding (ENERGIB-Turkey)", Turk J Gastroenterol, 23, pp.463~477 (2012)
  16. Barkun A, "The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting", Am J Gastroenterol, 99, pp.1238~1246 (2004)
  17. Crooks C, "Reductions in 28-day mortality following hospital admission for upper gastrointestinal hemorrhage", Gastroenterology, 141, pp.62~70 (2011)
  18. Manguso F, "In-hospital mortality in non-variceal upper gastrointestinal bleeding Forrest 1 patients", Scand J Gastroenterol, 43, pp.1432~1441 (2008)
  19. Leontiadis GI, "Effect of comorbidity on mortality in patients with peptic ulcer bleeding : systematic review and meta-analysis", Am J Gastroenterol, 108, pp.331~345 (2013)
  20. Nahon S, "Epidemiological and prognostic factors involved in upper gastrointestinal bleeding: results of a French prospective multicenter study", Endoscopy, 44, pp.998~1008 (2012)
  21. Sung JJ, "Causes of mortality in patients with peptic ulcer bleeding:a prospective cohort study of 10,428 cases", Am J Gastroenterol, 105, pp.84~89 (2010)
  22. Chiu PW, "Predicting mortality in patients with bleeding peptic ulcers after therapeutic endoscopy", Clin Gastroenterol Hepatol, 7, pp.311~316 (2009)
  23. Ishihara M, "Impact of admission hyperglycemia and diabetes mellitus on short- and longterm mortality after acute myocardial infarction in the coronary intervention era", Am J Cardiol, 99, pp.1674~1679 (2007)
  24. Cox AJ, "Usefulness of biventricular volume as a predictor of mortality in patients with diabetes mellitus(from the Diabetes Heart Study)", Am J Cardiol, 111, pp.1152~1158 (2013)
  25. Thomsen RW, "Diabetes and 30-day mortality from peptic ulcer bleeding and perforation: a Danish population-based cohort study", Diabetes Care, 29, pp.805~810 (2006)
  26. Atsuhiko Murata, "The Influence of Diabetes Mellitus on Short-Term Outcomes of Patients with Bleeding Peptic Ulcers", Yonsei Medical Journal, 53(4), pp.701~707 (2012), 연세대학교의과대학[DOI]
  27. Larche J, "Improved survival of critically ill cancer patients with septic shock", Intensive Care Med, 29, pp.1688~1695 (2003)
  28. Gisbert JP, "Meta-analysis: Helicobacter pylori eradication therapy vs. antisecretory non-eradication therapy for the prevention of recurrent bleeding from peptic ulcer", Aliment Pharmacol Ther, 19, pp.617~629 (2004)

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