title: Risk factors for recurrence of acute gastrointestinal bleeding from angiodysplasia.
abstract: OBJECTIVE
  Recurrent bleeding from gastrointestinal (GI) angiodysplasia remains a therapeutic challenge. Identification of factors predicting poor outcome of haemorrhage from angiodysplasia would help us to select the patients who may likely benefit from further therapy. Thus, we analysed risk factors for recurrence of acute GI haemorrhage from angiodysplasia.
  
  
  METHODS
  62 patients admitted consecutively with acute GI bleeding from angiodysplasia, between June 2002 and June 2006, were included. Bivariate, multivariate and survival analysis were performed to identify risk factors for recurrence of bleeding after hospital discharge.
  
  
  RESULTS
  Recurrence of acute haemorrhage after hospital discharge occurred in 17 of 57 (30%) patients (38 men; mean age: 74+/-6 years), after a mean follow-up (33+/-40 months). On Cox analysis, earlier history of bleeding with a high bleeding rate, over anticoagulation and the presence of multiple lesions were predictive factors of recurrence in a multivariate analysis. In contrast, endoscopic argon plasma coagulation (APC) therapy was not associated with lower rates of recurrent bleeding.
  
  
  CONCLUSIONS
  In patients with acute GI haemorrhage from angiodysplasia, earlier bleeding with a high bleeding rate, over anticoagulation and multiple angiodisplasic lesions predict an increased risk of recurrent bleeding. Although there is a trend towards better management with endoscopic APC therapy for the prevention of recurrence of bleeding, endoscopic APC therapy is not predictive of a lower rate of recurrence.
authors.affiliation: Gastroenterology Department, University Hospital Vall d'Hebron, Barcelona, Spain. esaperas@vhebron.net
authors.forename: Esteve
authors.initials: E
authors.lastname: Saperas
authors.forename: Sebastián
authors.initials: S
authors.lastname: Videla
authors.forename: Joan
authors.initials: J
authors.lastname: Dot
authors.forename: Carolina
authors.initials: C
authors.lastname: Bayarri
authors.forename: Beatriz
authors.initials: B
authors.lastname: Lobo
authors.forename: Monder
authors.initials: M
authors.lastname: Abu-Suboh
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Armengol
authors.forename: Juan R
authors.initials: JR
authors.lastname: Malagelada
mesh_terms: D000208:Acute Disease; D000368:Aged; D016888:Angiodysplasia / Q000150:complications* / Q000601:surgery; D057908:Argon Plasma Coagulation / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome