Risk factors for 30-day mortality in patients with head and neck cancer bleeding in the emergency department

Yen, Chieh-Ching; Yeh, Heng Liang; Ho, Che-Fang; Hsiao, Chien-Han; Niu, Kuang-Yu; Yeh, Chung-Cheng; Lu, Jian-Xun; Wu, Chien-Hung; Chang, Yun-Chen; Ng, Chip-Jin

doi:10.1016/j.ajem.2022.05.008

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…Second, all significant variables from the univariable analyses were inputted into the multivariable logistic regression model to further examine their statistical association. Continuous variables were categorized as a priori using either the standard threshold values established in our laboratory settings or thresholds associated with poor outcomes, as identified in the existing literature [17][18][19][20][21][22][23][24]. In the multivariable model, a p-value of < 0.05 was set as the threshold for the incorporation of variables into the final prediction score.…”

Section: Derivation Stagementioning

confidence: 99%

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Lu,

Niu,

Pai

et al. 2024

Cancers

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Purpose: To develop and internally validate a novel prediction score to predict the occurrence of arterial–esophageal fistula (AEF) in esophageal cancer bleeding. Methods: This retrospective cohort study enrolled patients with esophageal cancer bleeding in the emergency department. The primary outcome was the diagnosis of AEF. The patients were randomly divided into a derivation group and a validation group. In the derivation stage, a predictive model was developed using logistic regression analysis. Subsequently, internal validation of the model was conducted in the validation cohort during the validation stage to assess its discrimination ability. Results: A total of 257 patients were enrolled in this study. All participants were randomized to a derivation cohort (n = 155) and a validation cohort (n = 102). AEF occurred in 22 patients (14.2%) in the derivation group and 14 patients (13.7%) in the validation group. A predictive model (HEARTS-Score) comprising five variables (hematemesis, active bleeding, serum creatinine level >1.2 mg/dL, prothrombin time >13 s, and previous stent implantation) was established. The HEARTS-Score demonstrated a high discriminative ability in both the derivation and validation cohorts, with c-statistics of 0.90 (95% CI 0.82–0.98) and 0.82 (95% CI 0.72–0.92), respectively. Conclusions: By employing this novel prediction score, clinicians can make more objective risk assessments, optimizing diagnostic strategies and tailoring treatment approaches.

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Section: Derivation Stagementioning

confidence: 99%

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Lu,

Niu,

Pai

et al. 2024

Cancers

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“…HNC bleeding is a significant source of psychological burden for patients and their families, and acute, catastrophic bleeding can be challenging for frontline physicians [9,10]. Prior studies have evaluated clinical outcomes in patients with HNC bleeding [4,7,8,[11][12][13][14][15]. However, until now, no studies have analyzed risk factors for patients who are at increased risk of rebleeding.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Wang

Niu

et al. 2022

BMC Cancer

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Background Acute, catastrophic bleeding in patients with head and neck cancer (HNC) is challenging and also a burden for their families and frontline physicians. This study analyzed the risk factors for rebleeding and long-term outcomes in these patients with HNC. Methods Patients who presented to the emergency department (ED) with HNC bleeding were enrolled in this study (N = 231). Variables of patients with or without rebleeding were compared, and associated factors were investigated using Cox’s proportional hazard model. Results Of the 231 patients enrolled, 112 (48.5%) experienced a recurrent bleeding event. The cumulative rebleeding incidence rate was 23% at 30 days, 49% at 180 days, and 56% at 1 year. Multivariate Cox regression analyses demonstrated that overweight-to-obesity (HR = 0.52, 95% CI 0.28–0.98, p = 0.043), laryngeal cancer (hazard ratio [HR] = 2.13, 95% confidence interval [CI] 1.07–4.23, p = 0.031), chemoradiation (HR = 1.49, 95% CI 1.001–2.94, p = 0.049), and second primary cancer (HR = 1.75, 95% CI 1.13–2.70, p = 0.012) are significant independent predictors of rebleeding, and the prognostic factors for overall survival included underweight (HR = 1.89, 95% CI 1.22–2.93, p = 0.004), heart rate > 110 beats/min (HR = 1.58, 95% CI 1.04–2.39, p = 0.032), chemoradiation (HR = 2.31, 95% CI 1.18–4.52, p = 0.015), and local recurrence (HR = 1.74, 95% CI 1.14–2.67, p = 0.011). Conclusions Overweight-to-obesity is a protective factor, while laryngeal cancer, chemoradiation and a second primary cancer are risk factors for rebleeding in patients with HNC. Our results may assist physicians in risk stratification of patients with HNC bleeding.

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Risk factors and management for lethal bleeding in head and neck cancer patients

Lee¹,

Shueng²,

Hsu³

2023

The American Journal of Emergency Medicine

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Risk factors for 30-day mortality in patients with head and neck cancer bleeding in the emergency department

Cited by 5 publications

References 31 publications

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Risk factors and management for lethal bleeding in head and neck cancer patients

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