predictors of in-hospital mortality in patients with non-variceal upper gastrointestinal bleeding factores predictivos de mortalidad intrahospitalaria en pacientes con sangrado de tubo digestivo alto no variceal

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ID: 164652
2011
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Abstract
Objective: to determine the independent predictors of in-hospital death of Hispanic patients with nonvariceal upper gastrointestinal bleeding (NVUGB). Experimental design: prospective and observational trial. Patients: in a period between 2000 and 2009, all patients with NVUGB admitted to our hospital were studied. Demographical and clinical characteristics, endoscopic findings and laboratory tests were evaluated χ² and Mann-Whitney U analyses were performed for comparisons, and binary logistic regression was employed to identify independent predictors of in-hospital mortality. Results: 1,067 patients were included, 65% male with a mean age of 58.8 years. Mean number of comorbidities per patient was 1.6 ± 0.76. The most frequent cause of bleeding were gastric and duodenal ulcers (55.4%); 278 patients (25.8%) received endoscopic treatment of which 69.1% had combined therapy. Rebleeding occurred in 36 patients (3.4%) of which 50% died. In-hospital mortality was 10.2%, of which only 3.1% was associated to bleeding. When comparing causes of death among patients with and without comorbidities, only hypovolemic shock was found significative (48.3 vs. 25%; p = 0.020). Binary logistic regression found that the number of comorbidities, Rockall scale score; serum albumin < 2.6 g/dL on admission; rebleeding and length of hospital stay were independent risk factors of in-hospital mortality. Conclusion: the number of comorbidities, the Rockall scale score, an albumin level < 2.6 g/dL, the presence of rebleeding and hospital stay were predictors of in-hospital mortality in patients with NVUGB
Objetivo: determinar los factores de riesgo para mortalidad intrahospitalaria en pacientes hispanos con sangrado de tubo digestivo alto no variceal (STDANV). Diseño experimental: estudio prospectivo y observacional. Pacientes: del año 2000 al 2009 se estudiaron pacientes con STDANV. Se evaluaron variables demográficas y clínicas así como resultados de laboratorio y hallazgos endoscópicos. Se utilizaron análisis de χ² y U de Mann-Whitney para las comparaciones y de regresión logística binaria para la identificación de factores predictores de mortalidad. Resultados: se estudiaron 1.067 pacientes (65% hombres) con promedio de edad de 58,8 años. La media de comorbilidades por paciente fue 1,6 ± 0,76. La causa más frecuente de sangrado fueron las úlceras en estómago y duodeno (55,4%); 278 pacientes (25,8%) recibieron alguna forma de tratamiento endoscópico, siendo combinado en el 69,1%. Resangraron 36 pacientes (3,4%) de los cuales 50% fallecieron. La mortalidad intrahospitalaria fue del 10,2%, y el 3,1% se relacionó directamente al sangrado. Al comparar la mortalidad entre pacientes con y sin comorbilidades, solo la presencia de choque hipovolémico tuvo diferencias estadísticamente significativas (48,3 vs. 25%; p = 0,020). La regresión logística mostró que el número de comorbilidades, el puntaje de Rockall, la albúmina al ingreso < 2,6 g/dl, el resangrado y la estancia hospitalaria fueron factores de riesgo independientes para mortalidad. Conclusión: el número de comorbilidades, el puntaje de Rockall, la presencia de albúmina sérica < 2,6 g/dl, el resangrado y la estancia hospitalaria son predictores de mortalidad intrahospitalaria en pacientes hispanos con STDANV.
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Authors ;José Alberto González-González;Genaro Vázquez-Elizondo;Diego García-Compeán;Juan Obed Gaytán-Torres;Ángel Ricardo Flores-Rendón;Joel Omar Jáquez-Quintana;Aldo Azael Garza-Galindo;Martha Graciela Cárdenas-Sandoval;Héctor Jesús Maldonado-Garza
Journal chemistry of heterocyclic compounds
Year 2011
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082011000400005
Keywords
mortality predictive factors mortalidad Gastroenterology

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