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[Poor outcome factors associated to patients with lower digestive bleeding in a public hospital]. / Factores asociados a mal pronóstico en pacientes con sangrado digestivo bajo en un hospital público.
Rojas-Domínguez, Jorge Luis; Carvallo-Michelena, Alvaro; Piscoya, Alejandro; Guzmán, Edson.
Afiliação
  • Rojas-Domínguez JL; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
  • Carvallo-Michelena A; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
  • Piscoya A; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú; Hospital Guillermo Kaelin de la Fuente, Essalud. Lima, Perú.
  • Guzmán E; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú; Hospital Nacional Edgardo RebagliatiMartins, EsSalud. Lima, Perú.
Rev Gastroenterol Peru ; 36(4): 298-303, 2016.
Article em Es | MEDLINE | ID: mdl-28062865
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is an event that has shown an increase in complications and mortality rates in the last decades. Although some factors associated with poor outcome have been identified, there are several yet to be evaluated. OBJECTIVE: To identify risk factors for poor outcome in patients with LGIB in the Hospital Edgardo Rebagliati Martins of Lima, Peru. MATERIAL AND METHODS: A prospective analytic observational cohort study was made, and a census was conducted with all patients with acute LGIB between January 2010 and December 2013. The main variables were heart rate ≥100/min, systolic blood pressure <100 mmHg and low hematocrit (≤35%) at admission. Poor outcome was defined as any of the following: death during hospital stay, bleeding requiring transfusion of ≥4 blood packs, readmission within one month of hospital discharge, or the need for hemostatic surgery. RESULTS: A total of 341 patients with LGIB were included, of which 27% developed poor outcome and 2% died. Variables found to be statistically related to poor outcome were: heart rate ≥ 100/min at admission (RR: 1.75, IC 95% 1.23- 2.50), systolic blood pressure <100 mmHg at admission (RR: 2.18, IC 95% 1.49-3.19), hematocrit ≤35% at admission (RR: 1.98, IC 95% 1.23-3.18) and LGIB of unknown origin (RR: 2.74, IC 95% 1.73-4.36). CONCLUSIONS: Elevated heart rate at admission, systolic hypotension at admission, low hematocrit at admission and having a LGIB of unknown origin are factors that increase the risk of developing poor outcome, and these patients should be monitored closely due to their higher risk of complications.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Retais / Doenças do Colo / Hemorragia Gastrointestinal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Peru Idioma: Es Revista: Rev Gastroenterol Peru Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2016 Tipo de documento: Article País de publicação: Peru
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Retais / Doenças do Colo / Hemorragia Gastrointestinal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Peru Idioma: Es Revista: Rev Gastroenterol Peru Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2016 Tipo de documento: Article País de publicação: Peru