Factors predicting the postoperative outcome of lower gastrointestinal hemorrhage.
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).
Czymek
Ralf
R
Department of Surgery, University of Lübeck Medical School, Lübeck, Germany. ralf_czymek@web.de
Kempf
Alexander
A
Roblick
Uwe
U
Jungbluth
Thomas
T
Schmidt
Andreas
A
Limmer
Stefan
S
Kujath
Peter
P
Bruch
Hans-Peter
HP
Fischer
Frank
F
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
D006454:Hemoglobins