Fierro NDS, J ZJ, Gutiérrez ZB, Andalón KR, Monzón LR, Mendoza MA

Language: Spanish
References: 19
Page: 238-244
PDF size: 289.52 Kb.

ABSTRACT

Introduction: the fecal occult blood test (FOBT) is frequently requested in critically ill patients when gastrointestinal bleeding is suspected. Its real utility in clinical decision-making is controversial, since a positive result may lead to interventions without clear benefit. Material and methods: a retrospective cohort study was conducted in 314 ICU patients admitted between January 2024 and May 2025. Three groups were defined: FOBT positive (n = 62), FOBT negative (n = 13), and no FOBT (n = 239). The primary outcome was the performance of endoscopy; secondary outcomes included the need for blood transfusion and in-hospital mortality. Results: patients with a positive FOBT presented higher baseline severity and a greater prevalence of sepsis. In the multivariable analysis, a positive result was independently associated with a higher probability of transfusion (adjusted OR 3.39; 95%CI 1.78-6.43; p < 0.001), but not with the performance of endoscopy (p = 0.082) or with in-hospital mortality. Conclusions: in critically ill patients, a positive FOBT result is a strong predictor of transfusion but is not an independent indicator for endoscopy or mortality. Therefore, its utility as a standalone decision-making tool in the ICU is limited, and its results must be carefully interpreted within the broader clinical context to avoid unnecessary diagnostic cascades.

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