title: Factors predicting the postoperative outcome of lower gastrointestinal hemorrhage.
abstract: OBJECTIVE
  To examine the treatment outcome for patients with acute bleeding from the lower gastrointestinal tract requiring transfusion and acute surgical care as a function of various risk factors
  
  
  METHODS
  Between 1999 and 2007, we collected data on 59 patients (39 male and 20 female patients) who received surgical intervention for acute lower intestinal hemorrhage requiring transfusion at our university clinic. Treatment complications and mortality were analyzed retrospectively.
  
  
  RESULTS
  The average age of the patients in this study is 70.0 +/- 12.2 years (range, 39 to 97 years) with an overall mortality of 15.3%. Blood transfusions >10 U (p = 0.031), postoperative need for ventilation (p = 0.004), necessary reoperations (p = 0.016), and an initial hemoglobin level <80 g/L (p = 0.043) proved to be significant risk factors for death. Blood transfusions >10 U (p = 0.028), necessary reoperations (p = 0.001), and an initial hemoglobin level <80 g/L (p = 0.033) were found to be significant risk factors for postoperative complications. All other parameters have no significant impact.
  
  
  CONCLUSIONS
  The decisive factors for the outcome of lower gastrointestinal hemorrhage requiring surgery are the severity of bleeding, beginning of treatment (initial hemoglobin level, need for packed red blood cells), and treatment efficiency (necessary reoperation).
authors.affiliation: Department of Surgery, University of Lübeck Medical School, Lübeck, Germany. ralf_czymek@web.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Czymek
authors.forename: Alexander
authors.initials: A
authors.lastname: Kempf
authors.forename: Uwe
authors.initials: U
authors.lastname: Roblick
authors.forename: Thomas
authors.initials: T
authors.lastname: Jungbluth
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmidt
authors.forename: Stefan
authors.initials: S
authors.lastname: Limmer
authors.forename: Peter
authors.initials: P
authors.lastname: Kujath
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.forename: Frank
authors.initials: F
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000401:mortality; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000601:surgery*; D006454:Hemoglobins / Q000032:analysis; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007410:Intestinal Diseases / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins