In:
United European Gastroenterology Journal, Wiley, Vol. 6, No. 5 ( 2018-06), p. 684-690
Abstract:
The need for a blood transfusion, defined as hemoglobin 〈 70 g/L, is the measure for assessing the risk levels in patients with upper gastrointestinal bleeding (UGIB). However, not all patients with a low hemoglobin level have a poor prognosis. Objective We assessed the clinical predictive factors associated with poor short‐term prognosis in patients with a low hemoglobin level. Methods In this prospective cohort study, all consecutive patients with suspected acute UGIB at Tokyo Metropolitan Tama Medical Center were enrolled between 2008 and 2015. Then, we extracted those who needed a blood transfusion (hemoglobin 〈 70 g/L) and explored the variables associated with all‐cause mortality within 28 days after presentation. Results Among 1307 patients, 311 needed a blood transfusion and 13 (4.2%) died from all causes. The presence of high‐risk stigmata requiring endoscopic treatment (peptic ulcers; Forrest scores Ia, Ib and IIa; varices with current bleeding or signs of recent bleeding; and spurting or gushing bleeding or visible vessel in other diseases), diagnosed by emergency endoscopy, was a unique factor affecting mortality (odds ratio: 8.47, 95% confidence interval: 1.45–160, P = 0.01). Patients without high‐risk stigmata neither died from UGIB nor had rebleeding, irrespective of the hemoglobin levels. Conclusions Patients without high‐risk stigmata showed a good prognosis even if they needed a blood transfusion. This result could facilitate triage of patients with suspected acute UGIB who only need a blood transfusion.
Type of Medium:
Online Resource
ISSN:
2050-6406
,
2050-6414
DOI:
10.1177/2050640618764161
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2728585-6
Permalink