Document Detail


Risk factors for upper gastrointestinal rebleeding in critically ill patients.
MedLine Citation:
PMID:  17591058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: To determine the risk factors for rebleeding after upper gastrointestinal bleeding in critically ill patients. METHODOLOGY: We retrospectively analyzed the medical records of consecutive 60 patients undergoing bedside esophagogastroduodenoscopy between January 2000 and December 2004 for upper gastrointestinal bleeding that developed while in the ICU. RESULTS: Eight of the 60 patients died within 7 days after initial bleeding and two of the eight died due to upper gastrointestinal bleeding. Seven-day rebleeding rate was 34.6% (18/52). An additional 7 patients died within 30 days, none of whom died of upper gastrointestinal bleeding. Thirty-day rebleeding rate was 51.1% (23/45). In multiple logistic regression using selected significant variables, anemia (Hb < 9.0g/dL), and hypoalbuminemia (albumin < 3.0g/dL) for 7-day rebleeding, and hypoxia (PaO2 < 80mmHg), anemia (Hb < 9.0g/dL), and units of blood transfused (> or = 3) for 30-day rebleeding were the significant independent risk factors in critically ill patients. CONCLUSIONS: The results of this study suggest that underlying patients' conditions or the severity of initial upper gastrointestinal bleeding affect rebleeding in the ICU setting. Adequate general ICU care including the prevention of initial bleeding and correction of hypoxia, anemia, and hypoalbuminemia after bleeding could reduce the rebleeding risk.
Authors:
Jae Hee Cheon; Joo Sung Kim; Seong Joon Ko; Byong Duk Ye; Sang Gyun Kim; Hyun Chae Jung; In Sung Song
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  54     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2007 Apr-May
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  766-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Critical Illness
Female
Gastrointestinal Hemorrhage / diagnosis*
Humans
Intensive Care Units
Male
Middle Aged
Prognosis
Recurrence / prevention & control
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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