https://scholars.lib.ntu.edu.tw/handle/123456789/541063
標題: | Early risk stratification with simple clinical parameters for cirrhotic patients with acute upper gastrointestinal bleeding | 作者: | Hsu Y.-C. JYH-MING LIOU Chung C.-S. Tseng C.-H. Lin T.-L. CHIEH-CHANG CHEN MING-SHIANG WU HSIU-PO WANG |
公開日期: | 2010 | 出版社: | W.B. Saunders | 卷: | 28 | 期: | 8 | 起(迄)頁: | 884-890 | 來源出版物: | American Journal of Emergency Medicine | 摘要: | Objective: This study aimed to identify pre-endoscopic clinical parameters independently associated with 6-week mortality and to develop a prognostic model in cirrhotic patients with acute upper gastrointestinal (UGI) bleeding. Methods: A total of 542 consecutive admissions of 389 cirrhotic patients with acute UGI bleeding were retrospectively investigated. Pertinent clinical data obtained at the emergency department were analyzed. Multivariate logistic regression analysis was performed to determine risk factors for 6-week mortality and to develop a predictive model. Results: Forty-four patients (8.12%) died within 6 weeks. The 6-week mortality was independently associated with male sex, hepatocellular carcinoma, non-hepatocellular carcinoma malignancy, hypoxemia with peripheral oxygen saturation less than 95%, serum bilirubin, and prothrombin time. A predictive model consisting of these 6 simple parameters was built. The c statistic of our model was 0.84, significantly superior to that (0.71) of the model for end-stage liver disease score (P = .002). Conclusions: Simple pre-endoscopic clinical parameters are valuable for early risk stratification in cirrhotic patients with acute UGI bleeding. Our prognostic model warrants prospective validation by further studies. ? 2010 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77957347073&doi=10.1016%2fj.ajem.2009.04.037&partnerID=40&md5=ce0a907853201f8da197da4a5fe9cef5 https://scholars.lib.ntu.edu.tw/handle/123456789/541063 |
ISSN: | 0735-6757 | DOI: | 10.1016/j.ajem.2009.04.037 | SDG/關鍵字: | adult; aged; article; bilirubin blood level; controlled study; emergency ward; female; human; hypoxemia; liver cell carcinoma; liver cirrhosis; liver disease; major clinical study; male; mortality; oxygen saturation; priority journal; prognosis; prothrombin time; risk factor; upper gastrointestinal bleeding; blood; chi square distribution; complication; emergency health service; hematemesis; liver cirrhosis; middle aged; neoplasm; receiver operating characteristic; retrospective study; risk; statistical model; statistics and numerical data; bilirubin; Aged; Bilirubin; Chi-Square Distribution; Emergency Service, Hospital; Female; Hematemesis; Hospital Mortality; Humans; Liver Cirrhosis; Logistic Models; Male; Middle Aged; Neoplasms; Odds Ratio; Prognosis; Prothrombin Time; Retrospective Studies; Risk Factors; ROC Curve |
顯示於: | 醫學系 |
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