Risk factors for mortality among patients admitted with upper gastrointestinal bleeding at a tertiary hospital: a prospective cohort study

Moledina, Sibtain; Komba, Ewaldo V.

doi:10.1186/s12876-017-0712-8

Cited by 57 publications

(58 citation statements)

References 41 publications

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“…Jiménez et al [13] found that low plasma albumin level was a risk factor for GIB and death in hospitalized patients. Moreover, several studies had mentioned that serum ALT is a risk factor for upper GIB and death within 60 days [14]. The results of the above studies were consistent with our study.…”

Section: Discussionsupporting

confidence: 93%

“…Likewise, subsequent studies have confirmed that it can evaluate the risk of bleeding within 30 days after discharge, or even within 1 year, and the study population has been extended to all patients receiving dual antiplatelet therapy after PCI [21]. Systolic blood pressure [22], plasma albumin [13,22], hematocrit [12,23]and ALT [14]included in the model were applied as predictors of death because of GIB by other risk score, so the model may also has a certain ability to predict the mortality of GIB.…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

Zhang

Liu

Wang

et al. 2020

Preprint

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Background: Although the early use of a risk stratification score in gastrointestinal bleeding(GIB) is recommended, there has been no risk score for GIB in patients admitted to cardiology so far.Objective:To describe the risk factors of GIB and develop a new risk score model in patients admitted to cardiology. Methods: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB,A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort.Results: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and alanine aminotransferase(ALT) were associated with GIB . The model had a high predictive accuracy (AUROC 0.816; 95%CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841; 95% CI, 0.807~0.874). Besides,the prediction of the model better than HAS-BLED score(AUROC 0.557; 95%CI, 0.513~0.602) and CRUSADE score(AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay and in-hospital mortality all increased gradually(P< 0.001). Conclusions: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to cardiology.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

Zhang

Liu

Wang

et al. 2020

Preprint

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“…The present study records an association between leukocytosis, increased liver transaminases and total bilirubin as well as decreased serum albumin with a higher risk of mortality. This is consistent with the findings of Cannon et al, 21 and Moledina et al 22 They found that elevated leucocyte counts, serum ALT, serum total bilirubin, and a lack of endoscopy were independent mortality predictors.…”

Section: Follow-up Of Studied Patients After 6 Monthssupporting

confidence: 92%

Prognostic Factors Associated with Mortality in Cirrhotic Patients with Bleeding Varices

Eldesouky

Tawfik

Hagras

et al. 2019

IJRSMS

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Objective Bleeding gastroesophageal varices are a cause of high mortality among cirrhotic patients. Aim The aim of this study was to study prognostic factors for mortality in cirrhosis associated with variceal bleeding. Patients and Methods This prospective study was conducted on 100 cirrhotic patients admitted to the Tanta University Hospital with an acute first variceal bleeding episode. Baseline clinical, laboratory, and endoscopic findings were recorded at presentation. Results During the first 6 weeks 15 patients died, 3 following the initial bleed and 12 after an early rebleed. At 6 months, a further 21 patients had died. Statistical analysis utilizing the baseline data revealed that high early death rate was associated with number of blood units transfused, lower systolic blood pressure, thrombocytopenia, increased serum creatinine and international normalized ratio (INR). High MELD, AIMS56, acute physiology and chronic health evaluation II (APACHE II) and ROCKall scores were risk factors for mortality. Risk factors for early rebleeding included presence of diabetes mellitus, leucocytosis, high Child score, model for end-stage liver disease (MELD), AIMS56, and sepsis-associated organ failure assessment (SOFA) scores. A high Child score, presence of ascites, and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis, leucocytosis, elevated alanine transaminase, aspartate transaminase, bilirubin, INR, and creatinine as well as low albumin were associated with decreased survival. Conclusion High MELD, AIMS56, APACHE II, and ROCKall scores were risk factors for mortality after acute variceal bleeding. High death rate during the first 6 weeks is associated with anemia, hypotension, thrombocytopenia, increased serum creatinine, and INR. Decreased survival at 6 months is associated with increased Child score, presence of ascites and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis.

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“…It often results in bleeding varices than bleeding peptic ulcer disease. The main causes of varices in sub-Saharan Africa include periportal brosis due to S.mansoni infection and liver cirrhosis (hepatitis B/C and alcoholic liver disease) [1][2][3][4]. Upper gastrointestinal bleeding among patients with varices is a medical emergency that usually presents with hematemesis, melena, hypotension, severe anemia, and sometimes recurrent variceal hemorrhage [5].…”

Section: Introductionmentioning

confidence: 99%

Schistosomiasis, Upper Gastrointestinal Bleeding, and Health Related Quality of Life Measurements in Rural Africa

Opio

Kazibwe

Lalitha

et al. 2020

Preprint

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Introduction Health related quality of life (HRQOL) measurements, which include disability weights, are important endpoints of health care delivery. These measurements are scarce for patients with upper gastrointestinal bleeding (UGIB) in rural sub-Saharan Africa (SSA) where schistosomiasis is endemic. Methods and materials In 2014, we studied HRQOL measurements among patients with UGIB in SSA where schistosomiasis is endemic. Participants included adult inpatients and outpatients with a history of UGIB at a primary health facility. We measured HRQOL using the EuroQoL 5-dimension (EQ-VAS/EQ5D) instrument and derived disability weights from EQ-VAS and EQ5D measurements. We profiled each participant’s medical history, physical examination, laboratory tests, imaging, and endoscopy findings. These were summarized through descriptive and inferential statistics.Results We studied 107 participants with a median age of 45 years. All participants experienced ≥1 lifetime episode of UGIB, 60% were females, while 22% had acute severe UGIB requiring admission, 98% hepatic schistosomiasis, 90% splenomegaly, 80% had esophageal varices, and 20% had peptic ulcers. Most (80%) had ever received praziquantel for schistosomiasis. No participant had ever had an endoscopy for UGIB or received propranolol for prevention of recurrent variceal UGIB. Measures of the 5 dimensions of health revealed a large proportion of participants had problems related to self-care (76%), anxiety/depression (88%), and pain/discomfort (89%). Few participants had problems with mobility(37%). The mean/median EQ-VAS derived disability weights and EQ5D derived disability weights were 0.38/0.30 and 0.38/0.34, respectively. Participants with ascites, acute UGIB, and severe anemia were found to have the highest EQ-VAS and EQ5D median disability weights. At linear regression age, female gender, ascites, and acute UGIB predicted EQ-VAS derived disability weights [F(4,100)=9.35, p<0.0000,R-squared =0.27] and EQ5D derived disability weights [F(4,100)=23.24, p<0.0000, R-squared =0.44]. Within these models, all four factors were significantly predicted higher disability weights, P-value <0.05. Conclusions In our study, older age, female gender, those with ascites or acute UGIB had the highest disability weights, and the greatest probability of having higher disability weights among patients with a history of UGIB where schistosomiasis is endemic. These findings are unique and improve the definitions of different health states among patients with UGIB and schistosomiasis.

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Risk factors for mortality among patients admitted with upper gastrointestinal bleeding at a tertiary hospital: a prospective cohort study

Cited by 57 publications

References 41 publications

Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

Prognostic Factors Associated with Mortality in Cirrhotic Patients with Bleeding Varices

Schistosomiasis, Upper Gastrointestinal Bleeding, and Health Related Quality of Life Measurements in Rural Africa

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