Risk factors of postoperative upper gastrointestinal bleeding following colorectal resections.
There is limited data regarding the risk factors of postoperative upper GI bleeding (UGIB) in patients undergoing colorectal resection. We sought to identify risk factors of UGIB after colorectal resection. The NIS database was used to evaluate all patients who had colorectal resection complicated by UGIB between 2002 and 2010. Multivariate analysis using logistic regression was performed to quantify the association of preoperative variables with postoperative UGIB. We sampled a total of 2,514,228 patients undergoing colorectal resection, of which, 12,925 (0.5%) suffered a postoperative UGIB. The mortality of patients who had UGIB was significantly greater than patients without UGIB (14.9 vs. 4.7%; OR, 3.57; CI, 3.40-3.75; P < 0.01). Patients suffering from UGIB had an associated 14.9% inhospital mortality. History of chronic peptic ulcer disease (6.75; CI, 5.75-7.91; P < 0.01) and emergency admission (OR, 4.27; CI, 4.09-4.45; P < 0.01) are associated with UGIB. Duodenal ulcer as the source of bleeding is a mortality predictors of patients (OR, 1.71; CI, 1.49-1.97; P < 0.01). Postoperative UGIB occurs in less than 1 % of colorectal resections. However, patients suffering from postoperative UGIB are over three times more likely to die. Chronic peptic ulcer disease and emergency admission are respectively the strongest predictors of postoperative UGIB.
Department of Surgery, School of Medicine, University of California, Irvine, Orange, CA, USA.
Zhobin
Z
Moghadamyeghaneh
Steven D
SD
Mills
Alessio
A
Pigazzi
Joseph C
JC
Carmichael
Michael J
MJ
Stamos
D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000379:methods; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome