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Chronic Kidney Disease, Hemodynamic Instability, and Endoscopic High-Risk Appearance Are Associated with 30-Day Rebleeding in Patients with Non-Variceal Upper Gastrointestinal Bleeding

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Author(s)
Yoo Jin LeeEun Soo KimYu Jin HahKyung Sik ParkKwang Bum ChoByoung Kuk JangWoo Jin ChungJae Seok Hwang
Keimyung Author(s)
Lee, Yoo JinKim, Eun SooPark, Kyung SikCho, Kwang BumJang, Byoung KukChung, Woo JinHwang, Jae Seok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Korean Medical Science
Issued Date
2013
Volume
28
Issue
10
Keyword
Nonvariceal Upper Gastrointestinal BleedingRebleedingKidney FailureChronicPredictive Factors
Abstract
The results of studies that evaluated predictive factors for rebleeding in non-variceal upper
gastrointestinal bleeding are inconsistent. The aim of this study was to investigate
predictive factors for 30-day rebleeding in these patients. A consecutive 312 patients
presenting symptoms and signs of gastrointestinal bleeding were enrolled in this
prospective, observational study. Clinical and demographic characteristics and endoscopic
findings were evaluated for potential factors associated with 30-day rebleeding using
logistic regression analysis. Overall, 176 patients were included (male, 80.1%; mean age,
59.7 ± 16.0 yr). Rebleeding within 7 and 30 days occurred in 21 (11.9%) and 27 (15.3%)
patients, respectively. We found that chronic kidney disease (CKD) (OR, 10.29; 95% CI,
2.84-37.33; P < 0.001), tachycardia (pulse > 100 beats/min) during the admission (OR,
3.79; 95% CI, 1.25-11.49; P = 0.019), and Forrest classes I, IIa, and IIb (OR, 6.14; 95%
CI, 1.36-27.66; P = 0.018) were significant independent predictive factors for 30-day
rebleeding. However, neither Rockall nor Blatchford scores showed statistically significant
relationships with 30-day rebleeding in a multivariate analysis. CKD, hemodynamic
instability during hospitalization, and an endoscopic high-risk appearance are significantly
independent predictors of 30-day rebleeding in patients with non-variceal upper
gastrointestinal bleeding. These factors may be useful for clinical management of such
patients.
Keimyung Author(s)(Kor)
이유진
김은수
박경식
조광범
장병국
정우진
황재석
Publisher
School of Medicine
Citation
Yoo Jin Lee et al. (2013). Chronic Kidney Disease, Hemodynamic Instability, and Endoscopic High-Risk Appearance Are Associated with 30-Day Rebleeding in Patients with Non-Variceal Upper Gastrointestinal Bleeding. Journal of Korean Medical Science, 28(10), 1500–1506. doi: 10.3346/jkms.2013.28.10.1500
Type
Article
ISSN
1011-8934
DOI
10.3346/jkms.2013.28.10.1500
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33799
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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