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KMID : 1038120150480050385
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Clinical Endoscopy
2015 Volume.48 No. 5 p.385 ~ p.391
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Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions
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Park Sang-Hun
Lee Du-Hyeon
Park Chang-Hwan
Jeon Jin
Lee Ho-Jun
Lim Sung-Uk
Park Seon-Young
Kim Hyun-Soo
Choi Sung-Kyu
Rew Jong-Sun
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Abstract
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Background/Aims: Dieulafoy lesions (DLs) are a rare but significant cause of upper gastrointestinal bleeding. We aimed to define the clinical significance of rebleeding and identify the predictors of rebleeding and mortality in upper gastrointestinal Dieulafoy lesions (UGIDLs).
Methods: Patients diagnosed with UGIDLs between January 2004 and June 2013 were retrospectively evaluated. Multivariate logistic regression analyses were performed to define the predictors of rebleeding and mortality in patients with UGIDLs.
Results: The study group consisted of 81 male and 36 female patients. Primary hemostasis was achieved in 115 out of 117 patients (98.3%) with various endoscopic therapies. Rebleeding occurred in 10 patients (8.5%). The mortality rate was significantly higher in patients with rebleeding than in those without rebleeding (30.0% vs. 4.7%, p=0.020). Multivariate logistic regression analysis revealed that kidney disease (p=0.006) and infection (p=0.005) were significant predictors of rebleeding in UGIDLs and that kidney disease (p=0.004) and platelet count (p=0.013) were significant predictors of mortality.
Conclusions: Rebleeding has an important prognostic significance in patients with UGIDLs. Kidney disease and infection are major predictors of rebleeding and mortality in patients with UGIDLs.
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KEYWORD
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Gastrointestinal hemorrhage, Hemostasis, Endoscopy, Mortality
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