Factores de riesgo asociados a la mortalidad por hemorragia digestiva alta en pacientes de un hospital público: Estudio caso control / Risk factors associated to mortality by upper GI bleeding in patients from a public hospital: A case control study
Rev. gastroenterol. Perú
; 33(3): 223-229, jul.-set. 2013. ilus, graf, tab
Article
in Es
| LILACS, LIPECS
| ID: lil-692441
Responsible library:
PE1.1
RESUMEN
Objetivo:
Determinar y establecer los factores de riesgo asociados a la mortalidad por hemorragia digestiva alta (HDA) a los 30 días posteriores al episodio en el Hospital Nacional Cayetano Heredia, Lima, Perú. Materiales ymétodos:
Se realizó un estudio observacional analítico caso-control retrospectivo con una proporción caso control de 13, analizando 180 pacientes, siendo 135 los controles y 45 los casos. Se determinó por plausibilidad biológica como posibles factores de riesgo a 14 variables, con las cuales se realizó un análisis logístico bivariado y multivariado.Resultados:
Se encontró en el análisis logístico bivariado como variables relacionadas estadísticamente a la mortalidad edad (OR=1,02), hematemesis (OR=2,57), hemorragia digestiva alta intrahospitalaria (OR=4), cirrosis (OR=2,67), neoplasia maligna (OR=5,37), ingreso a la unidad de cuidados intensivos/Shock-Trauma (OR=9,29), score de Rockall mayor a 4 (OR=19,75), resangrado (OR=5,65), y paquetes globulares transfundidos (OR=1,22). Mientras que en el análisis logístico multivariado se encontró solamente a las variables neoplasia maligna (OR=5,35), ingreso a la unidad de cuidados intensivos/Shock-Trauma (OR=8,29), y score de Rockall mayor a 4 (OR=8,43).Conclusiones:
Los factores que aumentan el riesgo de mortalidad en pacientes con hemorragia digestiva alta son un score de Rockall mayor a 4, ingreso a la unidad de cuidados intensivos/Shock-Trauma, resangrado, hemorragia digestiva alta intrahospitalaria, cirrosis, presencia de hematemesis, neoplasia maligna, número de paquetes globulares transfundidos y edad.ABSTRACT
Objective:
Identify and establish risk factors associated with mortality secondary to upper gastrointestinal bleeding up to 30 days after the episode, at the Hospital Nacional Cayetano Heredia. Material andmethods:
A retrospective analytic observational case-control study was made with a case control proportion of 13, analyzing 180 patient from which 135 were the controls and 45 the cases. It was determined by biological plausibility as potential risk factors to 14 variables, with which were performed bivariate and multivariate logistic analyses.Results:
It was found in the bivariate logistic analysis as variables statistically related to mortality age (OR=1.02), hematemesis (OR=2.57), in-hospital upper gastrointestinal bleeding (OR=4), cirrhosis (OR=2.67), malignancy (OR=5,37), admittance to intensive care unit/Shock-Trauma (OR=9.29), Rockall score greater than 4 (OR=19.75), rebleeding (OR=5.65), and number of packed red blood cell transfusions(OR=1.22). While in the multivariate logistic analysis, the only variables statistically related to mortality were malignancy (OR=5.35), admittance to intensive care unit/Shock-Trauma (OR=8.29), and Rockall score greater than 4 (OR=8.43).Conclusions:
The factors that increase the risk of mortality in patient with upper gastrointestinal bleeding are Rockall score greater than 4, admittance to intensive care unit/Shock-Trauma, rebleeding, in-hospital upper gastrointestinal bleeding, cirrhosis, hematemesis, malignancy, the number of red blood cell transfusion, and age.Key words
Full text:
1
Database:
LILACS
Main subject:
Gastrointestinal Hemorrhage
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Language:
Es
Journal:
Rev. gastroenterol. Perú
Journal subject:
GASTROENTEROLOGIA
Year:
2013
Type:
Article
Affiliation country:
Peru