Rojas-Domínguez Jorge Luis, Carvallo-Michelena Alvaro, Piscoya Alejandro, Guzmán Edson
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú; Hospital Guillermo Kaelin de la Fuente, Essalud. Lima, Perú.
Rev Gastroenterol Peru. 2016 Oct-Dec;36(4):298-303.
Lower gastrointestinal bleeding (LGIB) is an event that has shown an increase in complications and mortality rates in the last decades. Although some factors associated with poor outcome have been identified, there are several yet to be evaluated.
To identify risk factors for poor outcome in patients with LGIB in the Hospital Edgardo Rebagliati Martins of Lima, Peru.
A prospective analytic observational cohort study was made, and a census was conducted with all patients with acute LGIB between January 2010 and December 2013. The main variables were heart rate ≥100/min, systolic blood pressure <100 mmHg and low hematocrit (≤35%) at admission. Poor outcome was defined as any of the following: death during hospital stay, bleeding requiring transfusion of ≥4 blood packs, readmission within one month of hospital discharge, or the need for hemostatic surgery.
A total of 341 patients with LGIB were included, of which 27% developed poor outcome and 2% died. Variables found to be statistically related to poor outcome were: heart rate ≥ 100/min at admission (RR: 1.75, IC 95% 1.23- 2.50), systolic blood pressure <100 mmHg at admission (RR: 2.18, IC 95% 1.49-3.19), hematocrit ≤35% at admission (RR: 1.98, IC 95% 1.23-3.18) and LGIB of unknown origin (RR: 2.74, IC 95% 1.73-4.36).
Elevated heart rate at admission, systolic hypotension at admission, low hematocrit at admission and having a LGIB of unknown origin are factors that increase the risk of developing poor outcome, and these patients should be monitored closely due to their higher risk of complications.
下消化道出血（LGIB）是一种在过去几十年中并发症和死亡率呈上升趋势的病症。尽管已经确定了一些与不良预后相关的因素，但仍有一些因素有待评估。
确定秘鲁利马埃加多·雷瓦利亚蒂·马丁斯医院LGIB患者不良预后的危险因素。
进行了一项前瞻性分析观察队列研究，并对2010年1月至2013年12月期间所有急性LGIB患者进行了普查。主要变量为入院时心率≥100次/分钟、收缩压<100 mmHg和血细胞比容低（≤35%）。不良预后定义为以下任何一种情况：住院期间死亡、出血需要输注≥4个血袋、出院后1个月内再次入院或需要进行止血手术。
共纳入341例LGIB患者，其中27%出现不良预后，2%死亡。发现与不良预后有统计学关联的变量为：入院时心率≥100次/分钟（RR：1.75，95%置信区间1.23 - 2.50）、入院时收缩压<100 mmHg（RR：2.18，95%置信区间1.49 - 3.19）、入院时血细胞比容≤35%（RR：1.98，95%置信区间1.23 - 3.18）以及不明原因的LGIB（RR：2.74，95%置信区间1.73 - 4.36）。
入院时心率升高、入院时收缩期低血压、入院时血细胞比容低以及不明原因的LGIB是增加不良预后风险的因素，由于这些患者并发症风险较高，应密切监测。
