Risk Factors Analysis for Long-Term Mortality in Patients Hospitalized for Acute Lower Gastrointestinal Bleeding

Aims The aim of this study was to identify the independent risk factors that predict long-term mortality after hospitalization for LGB.

Methods Patients with LGB were identified using the International Classification of Diseases (9th Revision) and Clinical Modification codes for admission diagnosis. A retrospective review of medical records and long-term follow-up were performed between January 2013 to December 2017. The follow-up was completed on January 1, 2020. Univariable and multivariable Cox regressions were performed to discover predictors of long-term mortality. For all analyses, we considered a P value lower than 0.05 was considered to be significant. The statistical analyses were performed in IBM SPSS version 22 (IBM Corp.,Armonk,NY,USA).

Results A total of 465 consecutive patients admitted with LGB were identified. Median age was 76.5 years (range 23-97), 309 (66,5 %) of patients were older than 70 years, 239 (51.4 %) were men. Six (1.3 %) died, 39 (8.4 %) presented a rebleeding, 20 (4.3 %) needed readmission, 124 (26.7 %) needed transfusion, 62 (13.3 %) needed treatment (58 endoscopic, 4 vascular embolization, 0 surgery). The most common cause of LGB was diverticular bleeding 133 (28.6 %).

The average follow-up was 7 years. One-year/two and four years mortality was 7 % (33/465), 13 % (60/465) and 24 % (102/465) respectively. The main cause of death was cardiovascular disorders, followed by neoplasic disease and respiratory disorders. The risk factors independently associated with seven-years mortality included: creatinine value greater ≥2 mg/dl (Hazard Ratio (HR) 3.4, 95 %CI 1.9-6.2, P<0.01), atrial fibrillation (HR 2.1, 95 %CI 1.6-2.9, P<0.01), severe bleeding (HR 2.2, 95%CI 1.5-3.1, P<0.01), readmission at 28 days (HR 2.1, 95%CI 1.1-4, P = 0.02) and old age (≥75 years) (HR 4.8, 95%CI 3.7- 7 P<0.01).

Conclusions Creatinine value ≥2mg/dl, atrial fibrillation, severe bleeding, readmission at 28 days and old age (≥75 years) were independent risk factors for long-term mortality in patients with LGB.

Citation: Frisancho E, Lovet LL, Brunet E etal. eP269 RISK FACTORS ANALYSIS FOR LONG-TERM MORTALITY IN PATIENTS HOSPITALIZED FOR ACUTE LOWER GASTROINTESTINAL BLEEDING. Endoscopy 2021; 53: S186.

Publication History

Article published online:
19 March 2021