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Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand

หน่วยงาน สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์

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ชื่อเรื่อง : Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand
นักวิจัย : Kessarin Thanapirom , Sombat Treeprasertsuk , Wiriyaporn Ridtitid , Rungsun Rerknimitr , Rattikorn Thungsuk , Phadet Noophun , Chatchawan Wongjitrat , Somchai Luangjaru , Padet Vedkijkul , Comson Lertkupinit , Swangphong Poonsab , Thawee Ratanachu-Ek , Piyathida Hansomburana , Bubpha Pornthisarn , Thirada Thongbai , Varocha Mahachai
คำค้น : Gastrointestinal bleeding
หน่วยงาน : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์
ผู้ร่วมงาน : -
ปีพิมพ์ : 2556
อ้างอิง : Gastrointestinal endoscopy. 77, 5 (2013) pp. AB326 , , http://dspace.library.tu.ac.th/handle/3517/7192
ที่มา : -
ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : -
บทคัดย่อ/คำอธิบาย :

Background Acute variceal upper gastrointestinal bleeding (AVUGIB) is common gastrointestinal emergency condition and has high mortality rate. We aim to determine the predictors for 30 days mortality in cirrhotic patients presenting with AVUGIB. Material and Methods We enrolled 238 cirrhotic patients with AVUGIB during January 1, 2010 and January 31, 2012 from 11 hospitals, prospectively. Data collection was performed by Clinical Research Collaboration Network (CRCN, Nonthaburi, Thailand). Predictors for mortality were identified by univariate and multivariate regression analysis. Diagnosis of cirrhotic patients is based on the clinical and/or radiographic evidence Results Of 238 cirrhotic patients with AVUGIB, 221 patients survived (93%) and 17 patients died within 30 days (7%). Baseline characteristic, history of alcohol consumption, co-morbidity, anti-platelets/NSAIDs usage, vasoactive agents usage, laboratory parameters, endoscopic finding/intervention and clinical outcomes was shown in table 1. Univariate analysis showed that non-survivors were significantly older, had more underlying chronic kidney disease, history of red nasogastric aspirate, use of vasoactive agent, international normalized ratio (INR) and serum creatinine. Presence of esophageal varices and gastric varices as well as endoscopic sign of recent bleeding including red color or white nipple sign were more commonly seen in non-survivors. Non-survivor had longer duration of hospital stay than survivor (12.4 +/− 14.0 vs 5.1 +/− 3.3, p<0.05). There were no different in unit of pack erythrocyte transfusion (3.1 +/− 2.2 vs 5.9 +/− 38.0, p=0.7), rebleeding in 48 hour (5.9% vs 0.5%, p=0.14) and surgery/intervention (0% vs 0.9%, p=0.89) between non-survivors and survivors. Multivariate analysis identified three predictors for 30 days mortality; use of vasoactive agents (OR 12.0, 95% CI 1.3-128.1, P = 0.03), INR >= 1.8 (OR 7.7, 95% CI 1.3-47.1, P = 0.03), serum creatinine >= 1.8 (OR 5.9, 95% CI 1.1-32.4, P = 0.04). Conclusion The predictors for 30 days mortality in cirrhotic patients presenting with AVUGIB were use of vasoactive agent, INR >= 1.8 and serum creatinine >= 1.8 Baseline characteristics, endoscopic findings/intervention and clinical outcome in patients with acute variceal upper gastrointestinal bleeding: survivors VS died. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

บรรณานุกรม :
Kessarin Thanapirom , Sombat Treeprasertsuk , Wiriyaporn Ridtitid , Rungsun Rerknimitr , Rattikorn Thungsuk , Phadet Noophun , Chatchawan Wongjitrat , Somchai Luangjaru , Padet Vedkijkul , Comson Lertkupinit , Swangphong Poonsab , Thawee Ratanachu-Ek , Piyathida Hansomburana , Bubpha Pornthisarn , Thirada Thongbai , Varocha Mahachai . (2556). Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand.
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ .
Kessarin Thanapirom , Sombat Treeprasertsuk , Wiriyaporn Ridtitid , Rungsun Rerknimitr , Rattikorn Thungsuk , Phadet Noophun , Chatchawan Wongjitrat , Somchai Luangjaru , Padet Vedkijkul , Comson Lertkupinit , Swangphong Poonsab , Thawee Ratanachu-Ek , Piyathida Hansomburana , Bubpha Pornthisarn , Thirada Thongbai , Varocha Mahachai . 2556. "Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand".
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ .
Kessarin Thanapirom , Sombat Treeprasertsuk , Wiriyaporn Ridtitid , Rungsun Rerknimitr , Rattikorn Thungsuk , Phadet Noophun , Chatchawan Wongjitrat , Somchai Luangjaru , Padet Vedkijkul , Comson Lertkupinit , Swangphong Poonsab , Thawee Ratanachu-Ek , Piyathida Hansomburana , Bubpha Pornthisarn , Thirada Thongbai , Varocha Mahachai . "Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand."
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ , 2556. Print.
Kessarin Thanapirom , Sombat Treeprasertsuk , Wiriyaporn Ridtitid , Rungsun Rerknimitr , Rattikorn Thungsuk , Phadet Noophun , Chatchawan Wongjitrat , Somchai Luangjaru , Padet Vedkijkul , Comson Lertkupinit , Swangphong Poonsab , Thawee Ratanachu-Ek , Piyathida Hansomburana , Bubpha Pornthisarn , Thirada Thongbai , Varocha Mahachai . Su1445 clinical predictors of 30 days mortality among patients with acute variceal upper gastrointestinal bleeding: multi-center prospective study in Thailand. กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ ; 2556.