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ISSN 1561-3046 (Electronic)

2016, Number 3

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Rev Cub Med Mil 2016; 45 (3)

Clinical parameters related to severity of the acute episode of non-varicosa high gastrointestinal bleeding

Infante VM, Roselló OR, Ramos CJY, García VM, Acosta GFA, Rodríguez ÁD

Language: Spanish
References: 24
Page: 267-276
PDF size: 145.41 Kb.


ABSTRACT

Introduction: The current strategies for diagnosis and treatment of patients with gastrointestinal bleeding include the identification of clinical and / or endoscopic factors to distinguish between those with severe bleeding and those who do not.
Objective: Identify clinical, analytical, and endoscopic parameters that predict the severity of non-varicose upper gastrointestinal bleeding.
Methods: A descriptive study of a series of cases was carried out in 188 patients treated with non-varicose upper gastrointestinal bleeding at the "Dr. Luis Díaz Soto" hospital from January 1st to December 31st, 2014. Measurement of clinical and endoscopic variables were taken. Univariate and multivariate analysis were performed by logistic regression method to identify those that could predict the severity of bleeding.
Results: Predictors of severe bleeding are: the consumption of NSAIDs (RR 2.28), having more than one associated disease (RR 1.01), the presence of melena as a sign of clinical presentation (RR 9,53) rectal examination (RR 2.87);as well as hemoglobin levels below 10 g/L (RR: 4.39) and HR greater than 100 beats per minute (RR 5.49). This probability is 3.4 times higher if hemoglobin is below 100 g/L and 2.4 times if the heart rate increases above 100 beats per minute.
Conclusions: The value of clinical signs and symptoms accompanying acute blood loss and haemodynamic changes to predict the likelihood of severe bleeding is confirmed.


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