title: [Poor outcome factors associated to patients with lower digestive bleeding in a public hospital].
abstract: BACKGROUND
  Lower gastrointestinal bleeding (LGIB) is an event that has shown an increase in complications and mortality rates in the last decades. Although some factors associated with poor outcome have been identified, there are several yet to be evaluated.
  
  
  OBJECTIVE
  To identify risk factors for poor outcome in patients with LGIB in the Hospital Edgardo Rebagliati Martins of Lima, Peru.
  
  
  METHODS
  A prospective analytic observational cohort study was made, and a census was conducted with all patients with acute LGIB between January 2010 and December 2013. The main variables were heart rate ≥100/min, systolic blood pressure <100 mmHg and low hematocrit (≤35%) at admission. Poor outcome was defined as any of the following: death during hospital stay, bleeding requiring transfusion of ≥4 blood packs, readmission within one month of hospital discharge, or the need for hemostatic surgery.
  
  
  RESULTS
  A total of 341 patients with LGIB were included, of which 27% developed poor outcome and 2% died. Variables found to be statistically related to poor outcome were: heart rate ≥ 100/min at admission (RR: 1.75, IC 95% 1.23- 2.50), systolic blood pressure <100 mmHg at admission (RR: 2.18, IC 95% 1.49-3.19), hematocrit ≤35% at admission (RR: 1.98, IC 95% 1.23-3.18) and LGIB of unknown origin (RR: 2.74, IC 95% 1.73-4.36).
  
  
  CONCLUSIONS
  Elevated heart rate at admission, systolic hypotension at admission, low hematocrit at admission and having a LGIB of unknown origin are factors that increase the risk of developing poor outcome, and these patients should be monitored closely due to their higher risk of complications.
authors.affiliation: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Rojas-Domínguez
authors.affiliation: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Carvallo-Michelena
authors.affiliation: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú; Hospital Guillermo Kaelin de la Fuente, Essalud. Lima, Perú.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Piscoya
authors.affiliation: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú; Hospital Nacional Edgardo RebagliatiMartins, EsSalud. Lima, Perú.
authors.forename: Edson
authors.initials: E
authors.lastname: Guzmán
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003108:Colonic Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006488:Hemostasis, Surgical / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006779:Hospitals, Public; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D010568:Peru; D011379:Prognosis; D012002:Rectal Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors