Proposal of a predictive scale for the non-variceal upper gastrointestinal bleeding
Keywords:
GASTROINTESTINAL HEMORRHAGE, RISK FACTORS, MORTALITY, LOGISTIC MODELSAbstract
Background: there is a general consensus as to the need to classify the patients with upper gastrointestinal bleeding in risk groups for a better medical care.
Objective: to create a prognostic scale for the non-variceal upper gastrointestinal bleeding, starting from the study of the risk factors that influence on its progress, which were assessed in a sample of patients attended to at the “Dr. Ernesto Guevara de la Serna” General Teaching Hospital of Las Tunas, from 2010 to 2014.
Methods: a case-control study was carried out with patients clinically diagnosed with non-variceal upper gastrointestinal bleeding, admitted for emergency in the aforementioned hospital and during the period herein declared. The sample was made up of 536 patients 19 years of age and older and divided into two groups: cases (212) and controls (324). The following variables were measured: sex, age group, presenting symptoms, comorbidity, initial systolic blood pressure, heart rate, initial hemoglobin, as well as at discharge. The statistic analysis was performed and taking into account the results of the logistic regression the proposal of the prognostic scale was made up.
Results: there was a prevalence of the male sex with 305 (56,90 %). The average age was 51,89 ± 9,63. The following risk factors were determined: age older than 65 years, systolic blood pressure lower than 100 mmHg, heart rate higher than 100 bpm, low hemoglobin, presence of hematemesis or nasogastric aspiration of blood and comorbidity with heart failure, renal failure and malignant diseases. The prognostic scale was elaborated based on these results.
Conclusions: a prognostic scale for the non-variceal upper gastrointestinal bleeding was created which included the risk factors assessed in the patients involved in the study.
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