title: Predictors of in-hospital mortality in patients with non-variceal upper gastrointestinal bleeding.
abstract: OBJECTIVE
  to determine the independent predictors of in-hospital death of Hispanic patients with nonvariceal upper gastrointestinal bleeding (NVUGB).
  
  
  METHODS
  prospective and observational trial.
  
  
  METHODS
  in a period between 2000 and 2009, all patients with NVUGB admitted to our hospital were studied. Demographical and clinical characteristics, endoscopic findings and laboratory tests were evaluated χ² and Mann-Whitney U analyses were per-formed for comparisons, and binary logistic regression was employed to identify independent predictors of in-hospital mortality.
  
  
  RESULTS
  1,067 patients were included, 65% male with a mean age of 58.8 years. Mean number of comorbidities per patient was 1.6 ± 0.76. The most frequent cause of bleeding were gastric and duodenal ulcers (55.4%); 278 patients (25.8%) received endoscopic treatment of which 69.1% had combined therapy. Rebleeding occurred in 36 patients (3.4%) of which 50% died. In-hospital mortality was 10.2%, of which only 3.1% was associated to bleeding. When comparing causes of death among patients with and without comorbidities, only hypovolemic shock was found significative (48.3 vs. 25%; p = 0.020). Binary logistic regression found that the number of comorbidities, Rockall scale score; serum albumin < 2.6 g/dL on admission; rebleeding and length of hospital stay were independent risk factors of in-hospital mortality.
  
  
  CONCLUSIONS
  the number of comorbidities, the Rockall scales core, an albumin level < 2.6 g/dL, the presence of rebleeding and hospital stay were predictors of in-hospital mortality in patients with NVUGB.
authors.affiliation: Department of Gastroenterology, Hospital Universitario de Monterrey Dr. José Eleuterio González y Escuela de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico. joseagonz@yahoo.com
authors.forename: José Alberto
authors.initials: JA
authors.lastname: González-González
authors.forename: Genaro
authors.initials: G
authors.lastname: Vázquez-Elizondo
authors.forename: Diego
authors.initials: D
authors.lastname: García-Compeán
authors.forename: Juan Obed
authors.initials: JO
authors.lastname: Gaytán-Torres
authors.forename: Ángel Ricardo
authors.initials: ÁR
authors.lastname: Flores-Rendón
authors.forename: Joel Omar
authors.initials: JO
authors.lastname: Jáquez-Quintana
authors.forename: Aldo Azael
authors.initials: AA
authors.lastname: Garza-Galindo
authors.forename: Martha Graciela
authors.initials: MG
authors.lastname: Cárdenas-Sandoval
authors.forename: Héctor Jesús
authors.initials: HJ
authors.lastname: Maldonado-Garza
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D016145:Endoscopy, Digestive System; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D012769:Shock / Q000209:etiology / Q000401:mortality
chemical_list: D054328:Proton Pump Inhibitors; D004837:Epinephrine