title: Risk factors for mortality in patients with Mallory-Weiss syndrome.
abstract: OBJECTIVE
  Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, in some patients MWS results in a fatal outcome. Therefore, this study was carried out to analyze the risk factors for mortality in patients with MWS.
  
  
  METHODS
  The medical records of patients with MWS seen between March 1994 and July 2007 were reviewed retrospectively. The demographic characteristics, clinical and laboratory parameters, and endoscopic findings of the patients were analyzed and the risk factors for mortality were evaluated.
  
  
  RESULTS
  A total of ninety-three patients (13 female and 80 male patients; median age, 53 years) were treated. The mortality rate was 9.7% (9/93). The patients with a fatal outcome were of advanced age and had a higher frequency of shock on arrival, lower hemoglobin level, more prolonged prothrombin time, higher AST and ALT levels, higher frequency of detection of exposed vessels on endoscopy, higher frequency of rebleeding, longer hospital stay, and required a larger volume of blood transfusion than those who did not have a fatal outcome. According to the results of a multivariate analysis, the significant risk factors for mortality in the MWS patients were advanced age (OR 1.222, 95% CI 1.015-1.028), very low hemoglobin level (OR 2.137, 95% CI 1.063-4.295), elevated AST level (OR 1.007, 95% CI 1.001-1.013), and presence of the clinical symptom of tarry stool (OR 45.45, 95% CI 1.080-1000).
  
  
  CONCLUSIONS
  Intensive care with close monitoring is required for patients of advanced age with a low hemoglobin level, an elevated AST level, and the clinical symptom of tarry stool, since these are of prognostic importance in terms of the mortality in MWS patients.
authors.affiliation: Department of Gastroenterology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Fujisawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sekino
authors.forename: Keiko
authors.initials: K
authors.lastname: Akimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Ayako
authors.initials: A
authors.lastname: Takahata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosono
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akiyama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Koide
authors.forename: Chikako
authors.initials: C
authors.lastname: Tokoro
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Kumiko
authors.initials: K
authors.lastname: Saito
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakamura
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Satoru
authors.initials: S
authors.lastname: Saito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Koyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase