Predictive factors of in-hospital mortality in patients with acute severe upper gastrointestinal bleeding
Abstract
Background: Older age, comorbidities and endoscopic stigmata of active bleeding are predictive factors of mortality in patients with acute upper gastrontestinal hemorrhage. Our aim was to assess independent predictors of in-hospital mortality of our patients with acute severe upper gastrointestinal bleeding.
Methods: We reviewed retrospectively charts of 54 patients admitted to ICU due to acute upper gastrointestinal bleeding as demonstrated endoscopically and /or with hypotension and/or tachicardia. Predictors of mortality were tested by univariate and multivariate statistical methods.
Results: Most frequent causes of bleeding were varices, followed by erosions and peptic ulcers. Mortality of our patients was 31.5 %. Between non-survivors and survivors statistically significant differences were observed in hemorhagic shock (82.4 % vs. 27 %, p < 0.001), heart failure (76.5 % vs. 18.9 %, p < 0.001), infection (47 % vs. 10.8 %, p = 0.005), admission diastolic blood pressure (55.4 ± 22 mm Hg vs. 69.7 ± 17.7 mmHg, p = 0.016), admission hemoglobin (74.2 ± 25.7 g/L vs. 94.2 ± 22.2 g/L, p = 0.005), erythrocytes (2.4 ± 0.7 10.1012/ L vs. 3 ± 0.7 10.1012/L, p = 0.005), lowest hemoglobin (65.8 ± 24.3 g/L vs. 80 ± 18.3 g/L, p = 0.02) and erythrocytes (2 ± 0.7 10.1012/L vs. 2.5 ± 0.6 10.1012/L, p = 0.007) during treatment. According to logistic regression the heart failure, followed by the lowest hemoglobin and erythrocytes were most significant independent predictors of mortality of our patients.
Conclusions: Variceal bleeding was most frequent cause of upper gastrointestinal hemorrhage. Heart failure was most significant independent predictor of in-hospital mortality, being 31.5 %.
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References
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