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Risk factors for mortality in lower intestinal bleeding.
Lisa L Strate1, John Z Ayanian, Gregory Kotler
1Division of Gastroenterology, University of Washington School of Medicine, Harborview Medical Center, Seattle, Washington 98104, USA. lstrate@u.washington.edu
Summary
In-hospital mortality for lower intestinal bleeding (LIB) was 3.9%. Advanced age, intestinal ischemia, and comorbid illness were the strongest predictors of death in LIB patients.
Area of Science:
- Gastroenterology
- Internal Medicine
- Epidemiology
Background:
- Previous studies on lower intestinal bleeding (LIB) had limited power to assess mortality.
- A large cohort study was needed to identify factors associated with in-hospital mortality in LIB patients.
Purpose of the Study:
- To identify patient characteristics associated with in-hospital mortality in a large cohort of patients hospitalized with lower intestinal bleeding (LIB).
Main Methods:
- Utilized the 2002 Healthcare Cost and Utilization Project Nationwide Inpatient Sample.
- Analyzed a cross-sectional cohort of 227,022 hospitalized patients with LIB diagnoses.
- Employed multiple logistic regression to identify predictors of mortality.
Main Results:
- The in-hospital mortality rate for LIB was 3.9% (8737 deaths).
- Independent predictors of mortality included advanced age, intestinal ischemia, comorbid illness, bleeding during hospitalization for another condition, coagulation defects, hypovolemia, red blood cell transfusion, and male gender.
- Colorectal polyps, hemorrhoids, and diagnostic testing for LIB were associated with reduced mortality risk.
Conclusions:
- The overall in-hospital mortality rate for lower intestinal bleeding (LIB) is low at 3.9%.
- Advanced age, intestinal ischemia, and significant comorbid illness are the most significant predictors of mortality in LIB patients.
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