Authors: Ryota Niikura Hideo Yasunaga Yutaka Yamaji Hiromasa Horiguchi Kiyohide Fushimi Atsuo Yamada Yoshihiro Hirata Kazuhiko Koike
Publish Date: 2014/09/03
Volume: 50, Issue: 5, Pages: 533-540
Abstract
Bleeding of the lower gastrointestinal tract requires hospitalization and can cause inhospital death in the most serious cases however only a few studies have evaluated inhospital death from bleeding of the lower gastrointestinal tract The aim of this study was to investigate the inhospital mortality of patients with bleeding of the lower gastrointestinal tract and elucidate the factors associated with it using a largescale databaseWe analyzed a nationwide database in Japan retrospectively From the Diagnosis Procedure Combination database we extracted data on patients who were admitted with visible blood in stool between July 1 2010 and March 31 2012 We assessed age sex comorbidity cause of bleeding type of hospital medications body mass index BMI and need for blood transfusion and treatments A multivariable logistic regression model was used to examine factors associated with blood transfusion and inhospital deathA total of 30846 patients were identified The median age was 74 years and 520 of patients were male A total of 782 patients died in hospital 25 and 8060 patients 261 needed blood transfusion In a multivariate analysis inhospital death was significantly associated with being older or male comorbidities including congestive heart failure renal disease and mild to severe liver disease the cause of bleeding a nonacademic hospital nonsteroidal antiinflammatory drug use lower BMI and requirements for blood transfusion interventional radiology and surgery Most factors were similarly associated with blood transfusionThis study was funded by grants from the Ministry of Health Labour and Welfare Japan Research on Policy Planning and Evaluation grant number H22Policy031 and the Council for Science and Technology Policy Japan Funding Program for WorldLeading Innovative RD on Science and Technology FIRST program grant number 0301002001001 The funders played no role in the design of the study data collection data analysis decision to publish the findings or preparation of the manuscript
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