Jo Namwoo, Oh Jaehoon, Kang Hyunggoo, Lim Tae Ho, Ko Byuk Sung
Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea.
Clin Exp Emerg Med. 2022 Jun;9(2):101-107. doi: 10.15441/ceem.21.099. Epub 2022 Jun 10.
To examine the association of inferior vena cava (IVC) diameter ratio measured using computed tomography with outcomes in patients with gastrointestinal bleeding (GIB).
A single-center retrospective observational study was conducted on consecutive patients with GIB who presented to the emergency department. The IVC diameter ratio was calculated by dividing the maximum transverse and anteroposterior diameters perpendicular to it. The association of the IVC diameter ratio with outcomes was examined using multivariable logistic regression analysis. The primary outcome was in-hospital mortality. The area under the receiver operator characteristic curve (AUC) of the IVC diameter ratio was calculated, and the sensitivity and specificity, including the cutoff values, were computed.
In total, 585 patients were included in the final analysis. The in-hospital mortality rate was 4.6% (n=27). The IVC diameter ratio was significantly associated with higher in-hospital mortality in multivariable logistic regression analysis (odds ratio, 1.793; 95% confidence interval [CI], 1.239-2.597; P=0.002). The AUC of the IVC diameter ratio for in-hospital mortality was 0.616 (95% CI, 0.498-0.735). With a cutoff of the IVC diameter ratio (≥2.1), the sensitivity and specificity for predicting in-hospital mortality were 44% (95% CI, 26%-65%) and 71% (95% CI, 67%-75%), respectively.
The IVC diameter ratio was independently associated with in-hospital mortality in patients with GIB. However, the AUC of the IVC diameter ratio for in-hospital mortality was low.
探讨利用计算机断层扫描测量的下腔静脉（IVC）直径比值与胃肠道出血（GIB）患者预后的相关性。
对连续就诊于急诊科的GIB患者进行单中心回顾性观察研究。IVC直径比值通过将最大横径与垂直于它的前后径相除来计算。采用多变量逻辑回归分析检验IVC直径比值与预后的相关性。主要结局是住院死亡率。计算IVC直径比值的受试者操作特征曲线（AUC）下面积，并计算敏感性和特异性，包括临界值。
最终分析共纳入585例患者。住院死亡率为4.6%（n = 27）。在多变量逻辑回归分析中，IVC直径比值与较高的住院死亡率显著相关（比值比，1.793；95%置信区间[CI]，1.239 - 2.597；P = 0.002）。IVC直径比值预测住院死亡率的AUC为0.616（95% CI，0.498 - 0.735）。IVC直径比值临界值（≥2.1）时，预测住院死亡率的敏感性和特异性分别为44%（95% CI，26% - 65%）和71%（95% CI，67% - 75%）。
IVC直径比值与GIB患者的住院死亡率独立相关。然而，IVC直径比值预测住院死亡率的AUC较低。
