Factores de riesgo asociados a hemorragia digestiva alta, en sala común

2004 
Upper gastrointestinal bleeding--UGB-, as a complication, is well studied at intensive care units (ICU), but is less known in non ICU settings. Objectives: To determine incidence and risk factors of this entity at clinical hospitalization. MATERIALS AND METHODS: A case-control study of patients with gastric ulcer disease diagnosed by endoscopy who presented with melena and hematemesis. Ten controls were taken for each case, matching sex, age and prophylaxis for gastric hemorrhage. Demographic data and other know risks factors were analyzed. RESULT: We found ten bleeding case among 35070 discharges (incidence: 2.8/10000 discharges). Mortality was not increased but the number of transfusion was higher in the bleeding group. We found an assocciation betwen UGB and systemic inflammatory response syndrome--SIRS-(OR: 9.22 IC 95% 2.98-28.17) and diabetes (OR: 7.8 IC 95% 2.3-26.8). The rest of the factors studied did not rich a statistical significance. CONCLUSIONS: UGB during clinical hospitalization is a rare complication that requires an increased staying at hospital and a great number of transfusions. It may be probably associated in a positive way with diabetes and SIRS.(AU) La hemorragia digestiva alta durante la internacion es una complicacion estudiada en unidades de cuidados criticos, pero se sabe poco de esta complicacion en sala comun. Objetivos: determinar la incidencia y factores de riesgo de esta patologia en sala comun. Materiales y Metodos: Estudio casocontrol. Definimos casos, pacientes con endoscopia digestiva realizada por melena o hematemesis, con diagnostico de enfermedad ulcerosa, se tomaron 10 controles por caso, controlando edad, sexo y uso de profilaxis ulcerosa. Se analizaron datos demograficos y factores de riesgo conocidos para esta patologia y se determino la incidencia en sala comun. Resultados: Se produjeron 10 episodios de sangrado sobre 35070 altas (Incidencia 2.8110.000 altas). No hubo mayor mortalidad en los casos pero si requirieron mayor numero de transfusiones (1.2 versus (vs) 0.07 paquetes de globulos rojos sedimentados en el grupo control. P=O.OOl) y tuvieron una mayor estadia hospitalaria (13.6 vs 6.8 dias en el grupo control. P=O.OOl). Existio una asociacion significativa entre hemorragia digestiva y presentar SIRS (aR: 9.22 IC95%: 2.9828.17) o Diabetes (aR: 7.8 IC95%: 2.326.8), el resto de los factores no alcanzaron significancia estadistica. Conclusion: La hemorragia digestiva durante la internacion es una entidad poco frecuente que requiere mayor estadia hospitalaria y necesidad de transfusiones. Asociada posiblemente en forma positiva al ingreso con SIRS, Diabetes, leucocitosis y taquicardia.(AU)
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