Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series
upper gastrointestinal bleeding (UGIB) is one of the main causes of hospital admission in gastroenterology departments and is associated with a significant morbidity and mortality. Rebleeding after initial endoscopic therapy occurs in 10-20% of cases and therefore, there is a need to define predicti...
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Veröffentlicht in: | Revista española de enfermedades digestivas 2019-03, Vol.111 (3), p.189-192 |
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creator | Jiménez Rosales, Rita Martínez-Cara, Juan Gabriel Vadillo-Calles, Francisco Ortega-Suazo, Eva Julissa Abellán-Alfocea, Patricia Redondo-Cerezo, Eduardo |
description | upper gastrointestinal bleeding (UGIB) is one of the main causes of hospital admission in gastroenterology departments and is associated with a significant morbidity and mortality. Rebleeding after initial endoscopic therapy occurs in 10-20% of cases and therefore, there is a need to define predictive factors for rebleeding.
the aim of our study was to analyze risk factors and outcomes in a population of patients who suffered a rebleed.
five hundred and seven patients with gastrointestinal bleeding were included. Clinical and biochemical data, as well as procedures and outcome six months after admission, were all collected. Documented clinical outcome included in-hospital and six-month delayed mortality, rebleeding and six-month delayed hemorrhagic and cardiovascular events.
according to a logistic regression analysis, high creatinine levels were independent risk factors for rebleeding of non-variceal and variceal UGIB. In non-variceal UGIB, tachycardia was an independent risk factor, whereas albumin levels were an independent protective factor. Rebleeding was associated with in-hospital mortality (29.5% vs 5.5%; p < 0.0001). In contrast, rebleeding was not related to six-month delayed mortality or delayed cardiovascular and hemorrhagic events.
tachycardia and high creatinine and albumin levels were independent factors associated with rebleeding, suggestive of a potential predictive role of these parameters. The incorporation of these variables into predictive scores may provide improved results for patients with UGIB. Further validation in prospective studies is required. |
doi_str_mv | 10.17235/reed.2018.5702/2018 |
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the aim of our study was to analyze risk factors and outcomes in a population of patients who suffered a rebleed.
five hundred and seven patients with gastrointestinal bleeding were included. Clinical and biochemical data, as well as procedures and outcome six months after admission, were all collected. Documented clinical outcome included in-hospital and six-month delayed mortality, rebleeding and six-month delayed hemorrhagic and cardiovascular events.
according to a logistic regression analysis, high creatinine levels were independent risk factors for rebleeding of non-variceal and variceal UGIB. In non-variceal UGIB, tachycardia was an independent risk factor, whereas albumin levels were an independent protective factor. Rebleeding was associated with in-hospital mortality (29.5% vs 5.5%; p < 0.0001). In contrast, rebleeding was not related to six-month delayed mortality or delayed cardiovascular and hemorrhagic events.
tachycardia and high creatinine and albumin levels were independent factors associated with rebleeding, suggestive of a potential predictive role of these parameters. The incorporation of these variables into predictive scores may provide improved results for patients with UGIB. Further validation in prospective studies is required.</description><identifier>ISSN: 1130-0108</identifier><identifier>DOI: 10.17235/reed.2018.5702/2018</identifier><identifier>PMID: 30569727</identifier><language>eng ; spa</language><publisher>Spain: Sociedad Espanola de Patologia Digestivas</publisher><subject>Aged ; Analysis of Variance ; Biomarkers - blood ; Blood Pressure ; Creatinine - blood ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices - complications ; Female ; Gastrointestinal Hemorrhage - etiology ; Gastrointestinal Hemorrhage - mortality ; Gastrointestinal Hemorrhage - therapy ; Hematemesis - etiology ; Hospital Mortality ; Humans ; Liver Cirrhosis - complications ; Male ; Melena - etiology ; Middle Aged ; Prospective Studies ; Recurrence ; Regression Analysis ; Risk Factors ; Serum Albumin - analysis ; Tachycardia - complications ; Treatment Outcome</subject><ispartof>Revista española de enfermedades digestivas, 2019-03, Vol.111 (3), p.189-192</ispartof><rights>COPYRIGHT 2019 Sociedad Espanola de Patologia Digestivas</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-d4d7f48bd2988c7fe29827edbec44783150b97ffcde1dd985fc474b1f5aa6ee13</citedby><cites>FETCH-LOGICAL-c451t-d4d7f48bd2988c7fe29827edbec44783150b97ffcde1dd985fc474b1f5aa6ee13</cites><orcidid>0000-0002-5932-8540</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,865,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30569727$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiménez Rosales, Rita</creatorcontrib><creatorcontrib>Martínez-Cara, Juan Gabriel</creatorcontrib><creatorcontrib>Vadillo-Calles, Francisco</creatorcontrib><creatorcontrib>Ortega-Suazo, Eva Julissa</creatorcontrib><creatorcontrib>Abellán-Alfocea, Patricia</creatorcontrib><creatorcontrib>Redondo-Cerezo, Eduardo</creatorcontrib><title>Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series</title><title>Revista española de enfermedades digestivas</title><addtitle>Rev Esp Enferm Dig</addtitle><description>upper gastrointestinal bleeding (UGIB) is one of the main causes of hospital admission in gastroenterology departments and is associated with a significant morbidity and mortality. Rebleeding after initial endoscopic therapy occurs in 10-20% of cases and therefore, there is a need to define predictive factors for rebleeding.
the aim of our study was to analyze risk factors and outcomes in a population of patients who suffered a rebleed.
five hundred and seven patients with gastrointestinal bleeding were included. Clinical and biochemical data, as well as procedures and outcome six months after admission, were all collected. Documented clinical outcome included in-hospital and six-month delayed mortality, rebleeding and six-month delayed hemorrhagic and cardiovascular events.
according to a logistic regression analysis, high creatinine levels were independent risk factors for rebleeding of non-variceal and variceal UGIB. In non-variceal UGIB, tachycardia was an independent risk factor, whereas albumin levels were an independent protective factor. Rebleeding was associated with in-hospital mortality (29.5% vs 5.5%; p < 0.0001). In contrast, rebleeding was not related to six-month delayed mortality or delayed cardiovascular and hemorrhagic events.
tachycardia and high creatinine and albumin levels were independent factors associated with rebleeding, suggestive of a potential predictive role of these parameters. The incorporation of these variables into predictive scores may provide improved results for patients with UGIB. Further validation in prospective studies is required.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biomarkers - blood</subject><subject>Blood Pressure</subject><subject>Creatinine - blood</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Esophageal and Gastric Varices - complications</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Gastrointestinal Hemorrhage - mortality</subject><subject>Gastrointestinal Hemorrhage - therapy</subject><subject>Hematemesis - etiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Melena - etiology</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Serum Albumin - analysis</subject><subject>Tachycardia - complications</subject><subject>Treatment Outcome</subject><issn>1130-0108</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkU1rGzEQhnVoaD7af1CKoFB6saPP1e7RhLQJBHppbwWhlUaOgiw50u4h_z5aO4EGgg4jZp5nkHgR-kLJmirG5WUBcGtGaL-WirDL5fYBnVHKyYpQ0p-i81ofCBG8k-wjOuVEdoNi6gz92yQTn2qoOHtcYIxtUUhbHBK2psKhbRKe93soeGvqVHJIE9QpNA8f8IU1uDYrArbQpgVXKAHqJ3TiTazw-aVeoL8_r_9c3azufv-6vdrcrayQdFo54ZQX_ejY0PdWeWiVKXAjWCFUz6kk46C8tw6oc0MvvRVKjNRLYzoAyi_Qj-PefcmPc3uc3oVqIUaTIM9VMyoHzpjqWEO_HdGtiaBD8nkqxi643sieCz6ojjdq_Q7VjoNdsDmBD63_Rvj-n3APJk73Ncd5CjnVt6A4grbkWgt4vS9hZ8qTpkQfstRLlnpJUC9ZHm5N-_ryw3nctfGr9BokfwbXRJwy</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Jiménez Rosales, Rita</creator><creator>Martínez-Cara, Juan Gabriel</creator><creator>Vadillo-Calles, Francisco</creator><creator>Ortega-Suazo, Eva Julissa</creator><creator>Abellán-Alfocea, Patricia</creator><creator>Redondo-Cerezo, Eduardo</creator><general>Sociedad Espanola de Patologia Digestivas</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>INF</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5932-8540</orcidid></search><sort><creationdate>201903</creationdate><title>Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series</title><author>Jiménez Rosales, Rita ; Martínez-Cara, Juan Gabriel ; Vadillo-Calles, Francisco ; Ortega-Suazo, Eva Julissa ; Abellán-Alfocea, Patricia ; Redondo-Cerezo, Eduardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-d4d7f48bd2988c7fe29827edbec44783150b97ffcde1dd985fc474b1f5aa6ee13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; spa</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biomarkers - blood</topic><topic>Blood Pressure</topic><topic>Creatinine - blood</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Esophageal and Gastric Varices - complications</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Gastrointestinal Hemorrhage - mortality</topic><topic>Gastrointestinal Hemorrhage - therapy</topic><topic>Hematemesis - etiology</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Melena - etiology</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Serum Albumin - analysis</topic><topic>Tachycardia - complications</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiménez Rosales, Rita</creatorcontrib><creatorcontrib>Martínez-Cara, Juan Gabriel</creatorcontrib><creatorcontrib>Vadillo-Calles, Francisco</creatorcontrib><creatorcontrib>Ortega-Suazo, Eva Julissa</creatorcontrib><creatorcontrib>Abellán-Alfocea, Patricia</creatorcontrib><creatorcontrib>Redondo-Cerezo, Eduardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale OneFile: Informe Academico</collection><collection>MEDLINE - Academic</collection><jtitle>Revista española de enfermedades digestivas</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiménez Rosales, Rita</au><au>Martínez-Cara, Juan Gabriel</au><au>Vadillo-Calles, Francisco</au><au>Ortega-Suazo, Eva Julissa</au><au>Abellán-Alfocea, Patricia</au><au>Redondo-Cerezo, Eduardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series</atitle><jtitle>Revista española de enfermedades digestivas</jtitle><addtitle>Rev Esp Enferm Dig</addtitle><date>2019-03</date><risdate>2019</risdate><volume>111</volume><issue>3</issue><spage>189</spage><epage>192</epage><pages>189-192</pages><issn>1130-0108</issn><abstract>upper gastrointestinal bleeding (UGIB) is one of the main causes of hospital admission in gastroenterology departments and is associated with a significant morbidity and mortality. Rebleeding after initial endoscopic therapy occurs in 10-20% of cases and therefore, there is a need to define predictive factors for rebleeding.
the aim of our study was to analyze risk factors and outcomes in a population of patients who suffered a rebleed.
five hundred and seven patients with gastrointestinal bleeding were included. Clinical and biochemical data, as well as procedures and outcome six months after admission, were all collected. Documented clinical outcome included in-hospital and six-month delayed mortality, rebleeding and six-month delayed hemorrhagic and cardiovascular events.
according to a logistic regression analysis, high creatinine levels were independent risk factors for rebleeding of non-variceal and variceal UGIB. In non-variceal UGIB, tachycardia was an independent risk factor, whereas albumin levels were an independent protective factor. Rebleeding was associated with in-hospital mortality (29.5% vs 5.5%; p < 0.0001). In contrast, rebleeding was not related to six-month delayed mortality or delayed cardiovascular and hemorrhagic events.
tachycardia and high creatinine and albumin levels were independent factors associated with rebleeding, suggestive of a potential predictive role of these parameters. The incorporation of these variables into predictive scores may provide improved results for patients with UGIB. Further validation in prospective studies is required.</abstract><cop>Spain</cop><pub>Sociedad Espanola de Patologia Digestivas</pub><pmid>30569727</pmid><doi>10.17235/reed.2018.5702/2018</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-5932-8540</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Aged Analysis of Variance Biomarkers - blood Blood Pressure Creatinine - blood Endoscopy, Gastrointestinal Esophageal and Gastric Varices - complications Female Gastrointestinal Hemorrhage - etiology Gastrointestinal Hemorrhage - mortality Gastrointestinal Hemorrhage - therapy Hematemesis - etiology Hospital Mortality Humans Liver Cirrhosis - complications Male Melena - etiology Middle Aged Prospective Studies Recurrence Regression Analysis Risk Factors Serum Albumin - analysis Tachycardia - complications Treatment Outcome |
title | Analysis of rebleeding in cases of an upper gastrointestinal bleed in a single center series |
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