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Risk factors for mortality in severe upper gastrointestinal bleeding
Frank Klebl1, Nicole Bregenzer, Lars Schöfer
1Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany. frank.klebl@klinik.uni-regensburg.de
International Journal of Colorectal Disease
|August 24, 2004
Summary
Mortality after upper gastrointestinal bleeding is high in tertiary care. Key risk factors include inpatient status, renal disease, coagulopathy, and glucocorticoid use, necessitating awareness of these elements.
Area of Science:
- Gastroenterology
- Internal Medicine
- Critical Care Medicine
Background:
- Upper gastrointestinal (GI) bleeding presents varied mortality risks in different patient populations.
- Tertiary care centers manage complex cases of upper GI bleeding requiring specific risk factor identification.
Purpose of the Study:
- To define the specific risk factors associated with mortality in patients undergoing endoscopy for upper GI bleeding at a tertiary care center.
Main Methods:
- Retrospective analysis of 362 patients with upper GI bleeding undergoing endoscopy.
- Comparison of characteristics, bleeding parameters, medications, and laboratory data between survivors and non-survivors.
Main Results:
- High in-hospital mortality (26.5%) observed, with 6.4% directly due to bleeding.
- Variceal bleeding, renal disease, liver disease, coagulopathy, and immunosuppression were linked to higher mortality.
- Logistic regression identified inpatient status, renal disease, coagulopathy, and glucocorticoid use as significant mortality risk factors.
Conclusions:
- Tertiary care settings experience substantial mortality rates from upper GI bleeding.
- Healthcare teams must recognize and address the specific risk factors prevalent in these high-risk patient groups.