1. Inhospital and delayed mortality after upper gastrointestinal bleeding: an analysis of risk factors in a prospective series
- Author
-
Rita Jiménez-Rosales, Francisco Valverde-López, Francisco Vadillo-Calles, Juan Gabriel Martínez-Cara, Eduardo Redondo-Cerezo, and Mercedes López de Hierro
- Subjects
Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Variceal bleeding ,Time Factors ,Multivariate analysis ,Adolescent ,Esophageal and Gastric Varices ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Neoplasms ,Internal medicine ,medicine ,Humans ,Upper gastrointestinal ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Young adult ,Prospective cohort study ,Aged ,Aged, 80 and over ,Series (stratigraphy) ,Inpatient mortality ,business.industry ,Gastroenterology ,Middle Aged ,medicine.disease ,Logistic Models ,Spain ,Multivariate Analysis ,Female ,030211 gastroenterology & hepatology ,Upper gastrointestinal bleeding ,Gastrointestinal Hemorrhage ,business - Abstract
Detailed analyses of mortality after upper gastrointestinal (GI) bleeding are lacking. Follow-up rarely extends beyond 30 days.Our aim was to analyze in-hospital and delayed 6-months mortality, identifying risk factors.This was a prospective study on patients with upper GI bleeding over 36 months. Clinical outcomes were in-hospital and delayed-6 month-mortality.Four hundred and forty-none patients were included. Overall inpatient mortality was 9.8% but mortality directly related to bleeding was 5.1%. Patients who died presented lower systolic blood pressures, platelet recounts, prothrombin times and lower levels of hemoglobin, calcium, albumin, urea, creatinine and total proteins. Cirrhosis and neoplasms determined a higher in-hospital mortality. Albumin levels were protective, whereas creatinine and an active bleeding were risk factors for in-hospital death in multivariate analysis. Up to 12.6% of patients discharged died in the first 6 months. Neoplasms, chronic kidney disease, coronary disease and esophageal varices were related to delayed mortality. Coronary disease and neoplasms were independent risk factors for mortality, but albumin levels were protective in multivariate analysis.Comorbidities were risk factors for delayed mortality, whereas albumin levels were a protective factor for in-hospital and delayed deaths. Six months mortality is proportionately as important as in-hospital mortality. Half of the delayed deaths might be preventable.
- Published
- 2018