AI Article Synopsis
- The study examined 114 patients who experienced gastrointestinal bleeding to identify clinical and imaging factors linked to arterial extravasation, rebleeding post-embolization, and 30-day mortality.
- Key findings revealed that a drop in hemoglobin levels predicted arterial extravasation, while younger age and a history of malignancy were associated with lower risk of rebleeding; however, malignancy increased the likelihood of it occurring.
- Predictors of 30-day mortality included hemodynamic instability before angiography, history of malignancy, the number of platelet transfusions, and rebleeding after treatment, with prophylactic embolization not influencing rebleed rates or mortality.
Article Abstract
Background And Aims: The aim of this study was to identify clinical and imaging predictors of arterial extravasation, post embolization rebleeding and 30-day mortality in gastrointestinal (GI) bleeding.
Method: This retrospective study included 114 patients who underwent angiography for upper or lower GI bleeding. Multivariate logistic regression was used to identify clinical and imaging predictors.
Results: Angiography demonstrated arterial extravasation in 22 patients (19%) and embolization was performed in 48 (42%) patients including prophylactic embolization in 26 (56%). Fall in hemoglobin level from baseline was an independent predictor of arterial extravasation with 65% increased odds for every unit drop (OR 1.65, 95%CI 1.13-2.40, p=0.01). Age <60 years was a negative predictor of rebleed within 30-days (OR 0.94, 95%CI 0.89-1.00, p=0.04). Patients with a history of malignancy were more likely to rebleed (OR 4.4, 95%CI 1.06-18.36, p=0.04). Hemodynamic instability prior to angiography (OR 13.22, 95%CI 1.65-106.07, p=0.02), history of malignancy (OR 1.36, 95%CI 1.49-10.49, p=0.01), number of units of platelets transfused (OR 1.42, 95%CI 1.02-1.97, p=0.04) and rebleed after angiography (OR 46.8, 95%CI 4.80-456.14, p<0.01) were predictors of 30-day mortality. Prophylactic embolization was not a predictor of rebleed or 30-day mortality.
Conclusions: This paper identified important clinical predictors of arterial extravasation, rebleed and 30-day mortality in GI bleedings, which will assist in patient selection and help to improve the overall angiographic management of GI bleeding.
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| http://dx.doi.org/10.15403/jgld.2014.1121.273.daz | DOI Listing |
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