Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer
Abstract
:1. Introduction
2. Methods
2.1. Patients
2.2. Data Collection
2.3. Definitions
2.4. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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AHRUs (n = 72) | Non-AHRUs (n = 315) | p Value | |
---|---|---|---|
Demographics | |||
Age: years | 79 (70.75, 85) | 74 (63, 81) | 0.0003 |
Sex: male: n | 36 (50%) | 186 (59%) | 0.15 |
ECOG-PS: score | 2 (1, 4) | 1 (0, 2) | <0.0001 |
CCI: score | 3 (1, 4.25) | 1 (0, 3) | <0.0001 |
In-hospital onset of bleeding: n | 50 (69.4%) | 56 (17.7%) | <0.0001 |
Systolic blood pressure: mmHg | 119 (97.5, 134.75) | 126 (108, 142) | 0.008 |
Heart rate: bpm | 85 (76, 100) | 80 (70, 93) | 0.005 |
Altered mental status: n | 9 (12.5%) | 11 (3.4%) | 0.005 |
Blood test | |||
Hemoglobin: g/dL | 10.05 (8.3, 11.725) | 11.2 (11.2, 13.3) | 0.015 |
Serum Albumin: g/dL | 2.8 (2.3, 3.2) | 3.6 (3.1, 4.1) | <0.0001 |
BUN: mg/dL | 24.2 (15.4, 34.9) | 18.2 (13.4, 27.9) | 0.003 |
Serum Creatinine | 0.8 (0.6, 1.3) | 0.8 (0.6, 1.1) | 0.59 |
INR | 1.1 (1, 1.4) | 1.0 (1, 1.2) | 0.021 |
Medication | |||
NSAIDs: n | 10 (13.8%) | 43 (13.7%) | 1.000 |
Antithrombotics: n | 35 (48.6%) | 134 (42.5%) | 0.43 |
Steroid: n | 10 (13.8%) | 26 (8.2%) | 0.16 |
Complication | |||
Diabetes mellitus: n | 21 (29.1%) | 56 (17.8%) | 0.034 |
Hypertension: n | 39 (54.1%) | 150 (47.6%) | 0.36 |
Hyperlipidemia: n | 17 (23.6%) | 69 (21.9%) | 0.76 |
Scoring | |||
CHAMPS score | 2.5 (2, 4) | 1 (0, 2) | <0.0001 |
NOBLADS score | 4 (3, 5) | 3 (2, 4) | <0.0001 |
ABC score | 3.5 (2, 7) | 2 (1, 4) | <0.0001 |
Factors | References | OR (95% CI), p Value | |
---|---|---|---|
Univariate | Multivariate | ||
Age: >65 years | ≤65 years | 2.42 (1.19–4.94), 0.015 | 4.03 (1.53–10.7), 0.005 |
Sex: male | female | 0.68 (0.41–1.14), 0.11 | 0.78 (0.39–1.55), 0.48 |
ECOG-PS: ≥2 | <2 | 3.67 (2.17–6.2), <0.0001 | 1.62 (0.81–3.24), 0.17 |
CCI: ≥2 | <2 | 2.63 (1.56–4.43), 0.0003 | 0.90 (0.42–1.94), 0.79 |
In-hospital onset of GI bleeding: yes | no | 10.4 (5.85–18.6), <0.0001 | 9.65 (4.60–20.6), <0.0001 |
Systolic blood pressure: <90 mmHg | ≥90 mmHg | 3.82 (1.84–7.90), 0.0003 | 4.01 (1.65–10.6), 0.005 |
Heart rate: >100 bpm | ≤100 bpm | 1.77 (0.95–3.32), 0.073 | 2.07 (0.90–4.77), 0.088 |
Altered mental status: yes | no | 3.92 (1.56–9.86), 0.0037 | 3.27 0.94–11.3), 0.062 |
Hemoglobin: <10.0 g/dL | ≥10.0 g/dL | 1.75 (1.04–2.93), 0.035 | 0.67 (0.30–1.48), 0.32 |
Serum albumin: <2.5 g/dL | ≥2.5 g/dL | 5.86 (3.10–11.10), <0.0001 | 2.07 (0.81–4.98), 0.12 |
BUN: >20 mg/dl | ≤20 mg/dl | 1.86 (1.11–3.15), <0.0001 | 1.78 (0.90–3.53), 0.10 |
INR: >1.5 | ≤1.5 | 1.41 (0.70–2.84), 0.37 | - |
NSAIDs: yes | no | 0.85 (0.41–1.77), 0.66 | - |
Antithrombotic drugs: yes | no | 1.26 (0.76–2.11), 0.37 | - |
Steroid: yes | no | 1.78 (0.82–3.88), 0.15 | 1.28 (0.43–3.82), 0.66 |
AHRUs (n = 72) | Non-AHRUs (n = 315) | p Value | |
---|---|---|---|
| 30 (41.6%) | 110 (34.9%) | 0.34 |
| 49 (68%) | 82 (26%) | <0.0001 |
| 30 (41.6%) | 73 (23.2%) | 0.003 |
| 11 (15.2%) | 61 (19.4%) | 0.86 |
| 10 (20.4%) | 20 (24.4%) | 0.67 |
| 13 (18%) | 26 (8.3%) | 0.027 |
Scoring | Rebleeding | In-Hospital Mortality | ||||||
---|---|---|---|---|---|---|---|---|
With | Without | p Value | AUC (95% CI) | With | Without | p Value | AUC (95% CI) | |
CHAMPS | 4 (2.5, 4) | 2 (2, 3) | 0.08 | 0.66 (0.49–0.84) | 3 (2, 4) | 2 (2, 4) | 0.40 | 0.57 (0.39–0.76) |
NOBLADS | 4 (3, 4) | 4 (4, 5) | 0.04 | 0.69 (0.55–0.83) | 4 (4, 5) | 4 (3, 5) | 0.24 | 0.60 (0.44–0.76) |
ABC | 2 (2, 5) | 4 (2, 7) | 0.30 | 0.60 (0.42–0.77) | 5 (2, 7) | 3 (2, 7) | 0.36 | 0.58 (0.43–0.73) |
Factors | Reference | Rebleeding | In-Hospital Mortality | ||
---|---|---|---|---|---|
Univariate CI (95% CI), p Value | Multivariate CI (95% CI), p Value | Univariate CI (95% CI), p Value | Multivariate CI (95% CI), p Value | ||
Age: >65 years | ≤65 years | 0.40 (0.09–1.84), 0.24 | - | 0.99 (0.19–5.24), 0.99 | - |
Sex: male | female | 0.81 (0.22–2.93), 0.74 | - | 2.67 (0.74–9.63), 0.13 | 2.68 (0.69–10.4), 0.15 |
ECOG-PS: ≥2 | Score = 0 or 1 | 1.06 (0.279–4.02), 0.93 | - | 0.64 (0.19–2.17), 0.48 | - |
CCI: ≥2 | Score = 0 or 1 | 0.42 (0.11–1.60), 0.21 | - | 2.82 (0.57–14.0), 0.20 | - |
In-hospital onset of bleeding: yes | no | 5.25 (0.63–43.8), 0.13 | 4.09 (0.41–40.6), 0.23 | 0.99 (0.27–3.63), 0.98 | - |
Systolic blood pressure: <90 mmHg | ≥90 mmHg | 4.25 (1.08–16.7), 0.04 | 3.28 (0.68–15.8), 0.14 | 1.94 (0.50–7.46), 0.33 | - |
Hemoglobin: <10.0 g/dL | ≥10.0 g/dL | 6.48 (1.29–32.6), 0.02 | 4.50 (0.59–34.7), 0.15 | 1.38 (0.41–4.61), 0.60 | - |
Serum albumin: <2.5 g/dL | ≥2.5 g/dL | 3.91 (1.01–15.2), 0.049 | 1.14 (0.19–6.99), 0.89 | 3.70 (1.05–13.1), 0.04 | 4.07 (1.11–14.9), 0.03 |
INR: >1.5 | ≤1.5 | 0.38 (0.04–3.30), 0.38 | - | 0.26 (0.03–2.53), 0.27 | - |
Antithrombotic drugs: yes | no | 0.55 (0.15–2.08), 0.38 | - | 0.60 (0.18–4.01), 0.42 | - |
Steroid: yes | no | 5.24 (1.18–23.2), 0.029 | 3.88 (0.70–21.5), 0.12 | 0.46 (0.053–4.01), 0.48 | - |
Rebleeding: yes | no | - | - | 1.01 (0.19–5.34), 0.27 | - |
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Takahashi, Y.; Shimodaira, Y.; Matsuhashi, T.; Tsuji, T.; Fukuda, S.; Sugawara, K.; Saruta, Y.; Watanabe, K.; Iijima, K. Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer. Diagnostics 2022, 12, 2487. https://doi.org/10.3390/diagnostics12102487
Takahashi Y, Shimodaira Y, Matsuhashi T, Tsuji T, Fukuda S, Sugawara K, Saruta Y, Watanabe K, Iijima K. Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer. Diagnostics. 2022; 12(10):2487. https://doi.org/10.3390/diagnostics12102487
Chicago/Turabian StyleTakahashi, Yasutaka, Yosuke Shimodaira, Tamotsu Matsuhashi, Tsuyotoshi Tsuji, Sho Fukuda, Kae Sugawara, Youhei Saruta, Kenta Watanabe, and Katsunori Iijima. 2022. "Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer" Diagnostics 12, no. 10: 2487. https://doi.org/10.3390/diagnostics12102487
APA StyleTakahashi, Y., Shimodaira, Y., Matsuhashi, T., Tsuji, T., Fukuda, S., Sugawara, K., Saruta, Y., Watanabe, K., & Iijima, K. (2022). Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer. Diagnostics, 12(10), 2487. https://doi.org/10.3390/diagnostics12102487