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In-hospital mortality risk estimation in patients with acute nonvariceal upper gastrointestinal bleeding undergoing hemodialysis: a retrospective cohort study.
Ren Fail. 2013; 35(2):243-8.RF

Abstract

BACKGROUND

Upper gastrointestinal bleeding (UGIB) is a major cause of clinical bleeding among patients with end-stage renal disease (ESRD). This study aimed to investigate the association between mortality and UGIB in patients with uremia.

METHODS

From 2004 to 2010, a tertiary hospital-based retrospective cohort comprising 322 patients undergoing hemodialysis was investigated. All the patients were diagnosed with UGIB according to the International Classification of Diseases, 9th Revision (ICD-9) that included peptic ulcer bleeding, duodenal ulcer bleeding, and other symptoms. UGIB was required to be one of the first three discharge diagnoses. Rehospitalization within 3 days after discharge was regarded as the same course. Exclusion criteria were age <20 years, previous gastric resection or vagotomy, esophageal and gastric variceal bleeding, or gastric cancer within the first 2 years of the index hospitalization.

RESULTS

The all-cause in-hospital mortality rate of patients with UGIB undergoing hemodialysis was high, with the first-month mortality rate of 13.7%, sixth-month mortality rate of 26.7%, and first-year mortality rate of 27.0%. Using Cox regression models, we found that the high mortality rate of the UGIB group was significantly correlated with older age [adjusted hazard ratio (HR) = 1.02, 95% confidence interval (CI) = 1.01-1.04], female sex (adjusted HR = 1.62, 95% CI = 1.05-2.51), infection during hospitalization (adjusted HR = 1.85, 95% CI = 1.13-3.03), single episodic UGIB (adjusted HR = 2.00, 95% CI = 1.08-3.70), abnormal white blood cell (WBC) count (adjusted HR = 1.59, 95% CI = 1.03-2.45), and albumin level ≤3 g/dL (adjusted HR = 2.67, 95% CI = 1.51-4.72).

CONCLUSION

In conclusion, patients with ESRD who are admitted with primary UGIB have a profoundly increased risk of all-cause in-hospital mortality during the follow-up period.

Authors+Show Affiliations

Center of Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23336331

Citation

Weng, Shuo-Chun, et al. "In-hospital Mortality Risk Estimation in Patients With Acute Nonvariceal Upper Gastrointestinal Bleeding Undergoing Hemodialysis: a Retrospective Cohort Study." Renal Failure, vol. 35, no. 2, 2013, pp. 243-8.
Weng SC, Shu KH, Tarng DC, et al. In-hospital mortality risk estimation in patients with acute nonvariceal upper gastrointestinal bleeding undergoing hemodialysis: a retrospective cohort study. Ren Fail. 2013;35(2):243-8.
Weng, S. C., Shu, K. H., Tarng, D. C., Tang, Y. J., Cheng, C. H., Chen, C. H., Yu, T. M., Chuang, Y. W., Huang, S. T., Sheu, W. H., & Wu, M. J. (2013). In-hospital mortality risk estimation in patients with acute nonvariceal upper gastrointestinal bleeding undergoing hemodialysis: a retrospective cohort study. Renal Failure, 35(2), 243-8. https://doi.org/10.3109/0886022X.2012.747140
Weng SC, et al. In-hospital Mortality Risk Estimation in Patients With Acute Nonvariceal Upper Gastrointestinal Bleeding Undergoing Hemodialysis: a Retrospective Cohort Study. Ren Fail. 2013;35(2):243-8. PubMed PMID: 23336331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In-hospital mortality risk estimation in patients with acute nonvariceal upper gastrointestinal bleeding undergoing hemodialysis: a retrospective cohort study. AU - Weng,Shuo-Chun, AU - Shu,Kuo-Hsiung, AU - Tarng,Der-Cherng, AU - Tang,Yih-Jing, AU - Cheng,Chi-Hung, AU - Chen,Cheng-Hsu, AU - Yu,Tung-Min, AU - Chuang,Ya-Wen, AU - Huang,Shih-Ting, AU - Sheu,Wayne Huey-Herng, AU - Wu,Ming-Ju, Y1 - 2013/01/22/ PY - 2013/1/23/entrez PY - 2013/1/23/pubmed PY - 2013/8/16/medline SP - 243 EP - 8 JF - Renal failure JO - Ren Fail VL - 35 IS - 2 N2 - BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a major cause of clinical bleeding among patients with end-stage renal disease (ESRD). This study aimed to investigate the association between mortality and UGIB in patients with uremia. METHODS: From 2004 to 2010, a tertiary hospital-based retrospective cohort comprising 322 patients undergoing hemodialysis was investigated. All the patients were diagnosed with UGIB according to the International Classification of Diseases, 9th Revision (ICD-9) that included peptic ulcer bleeding, duodenal ulcer bleeding, and other symptoms. UGIB was required to be one of the first three discharge diagnoses. Rehospitalization within 3 days after discharge was regarded as the same course. Exclusion criteria were age <20 years, previous gastric resection or vagotomy, esophageal and gastric variceal bleeding, or gastric cancer within the first 2 years of the index hospitalization. RESULTS: The all-cause in-hospital mortality rate of patients with UGIB undergoing hemodialysis was high, with the first-month mortality rate of 13.7%, sixth-month mortality rate of 26.7%, and first-year mortality rate of 27.0%. Using Cox regression models, we found that the high mortality rate of the UGIB group was significantly correlated with older age [adjusted hazard ratio (HR) = 1.02, 95% confidence interval (CI) = 1.01-1.04], female sex (adjusted HR = 1.62, 95% CI = 1.05-2.51), infection during hospitalization (adjusted HR = 1.85, 95% CI = 1.13-3.03), single episodic UGIB (adjusted HR = 2.00, 95% CI = 1.08-3.70), abnormal white blood cell (WBC) count (adjusted HR = 1.59, 95% CI = 1.03-2.45), and albumin level ≤3 g/dL (adjusted HR = 2.67, 95% CI = 1.51-4.72). CONCLUSION: In conclusion, patients with ESRD who are admitted with primary UGIB have a profoundly increased risk of all-cause in-hospital mortality during the follow-up period. SN - 1525-6049 UR - https://www.unboundmedicine.com/medline/citation/23336331/In_hospital_mortality_risk_estimation_in_patients_with_acute_nonvariceal_upper_gastrointestinal_bleeding_undergoing_hemodialysis:_a_retrospective_cohort_study_ L2 - http://www.tandfonline.com/doi/full/10.3109/0886022X.2012.747140 DB - PRIME DP - Unbound Medicine ER -