Abstract:
Background: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.
journal_name
United European Gastroenterol Jjournal_title
United European gastroenterology journalauthors
Horibe M,Ogura Y,Matsuzaki J,Kaneko T,Yokota T,Okawa O,Nakatani Y,Iwasaki E,Nishizawa T,Hosoe N,Masaoka T,Yahagi N,Namiki S,Kanai Tdoi
10.1177/2050640618764161subject
Has Abstractpub_date
2018-06-01 00:00:00pages
684-690issue
5eissn
2050-6406issn
2050-6414pii
10.1177_2050640618764161journal_volume
6pub_type
杂志文章abstract:OBJECTIVE:To determine the survival outcome and prognostic factors of hepatocellular carcinoma (HCC) survival in patients who underwent radiofrequency ablation (RFA). METHODS:The Surveillance, Epidemiology and End Results (SEER) database was queried: There were 2588 HCC patients from 2004 to 2012 who underwent RFA. Th...
journal_title:United European gastroenterology journal
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