Predictors of in-hospital mortality in patients with non-variceal upper gastrointestinal bleeding

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 hospit...

Descripción completa

Detalles Bibliográficos
Autores principales: González González, José Alberto, Vázquez Elizondo, Genaro, García Compeán, Diego, Obed Gaytán Torres, Juan, Flores Rendón, Ángel Ricardo, Jáquez Quintana, Joel Omar, Garza Galindo, Aldo Azael, Cárdenas Sandoval, Martha Graciela, Maldonado Garza, Héctor Jesús
Formato: Artículo
Lenguaje:inglés
Publicado: Sociedad Española de Patología Digestiva 2011
Acceso en línea:http://eprints.uanl.mx/30198/1/30198.pdf
Descripción
Sumario: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. Inhospital 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 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 UNVGB.