The identification of high-risk patients with lower intestinal tract bleeding (LIB) is challenging. Prognostic factors have not been clearly defined.
In this study, researchers from the United States determined the risk factors for severe acute LIB.
The research team identified 252 consecutive patients admitted with acute LIB.
|Severe lower intestinal bleeding occurred in 49% of the patients.|
|Archives of Internal Medicine|
They collected data on 24 clinical factors, available in the first 4 hours of evaluation.
The outcome was severe bleeding. This was defined as continued bleeding within the first 24 hours of hospitalization and/or recurrent bleeding after 24 hours of stability.
The team found that severe LIB occurred in 49% of the patients.
The research team identified several independent correlates of severe bleeding:
- heart rate, 100/min (odds ratio [OR], 3.67)
- systolic blood pressure, 115 mm Hg (OR, 3.45)
- syncope (OR, 2.82)
- nontender abdominal examination (OR, 2.43)
- bleeding per rectum during the first 4 hours of evaluation (OR, 2.32)
- aspirin use (OR, 2.07)
- and more than 2 active comorbid conditions (OR, 1.93).
Dr Lisa Strate's team concluded, "Clinical data available on initial evaluation can be used to identify patients at risk for severe LIB, who may benefit most from urgent intervention".