Clin Endosc.  2015 Sep;48(5):385-391. 10.5946/ce.2015.48.5.385.

Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions

• Park SH
• Lee DH
• Park CH
• Jeon J
• Lee HJ
• Lim SU
• Park SY
• Kim HS
• Choi SK
• Rew JS

• KMID: 2148549
• DOI: http://doi.org/10.5946/ce.2015.48.5.385

Abstract

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.

Keyword

Gastrointestinal hemorrhage; Hemostasis; Endoscopy; Mortality

MeSH Terms

Endoscopy
Female
Gastrointestinal Hemorrhage
Hemorrhage
Hemostasis
Humans
Kidney Diseases
Logistic Models
Male
Mortality
Platelet Count
Retrospective Studies

Figure

• 

  Fig. 1 Flow diagram of the study showing entries and outcomes of all patients. UGIB, upper gastrointestinal bleeding; DLs, Dieulafoy lesions; UGIDLs, upper gastrointestinal Dieulafoy lesions; AKI, acute kidney injury; CKD, chronic kidney disease; DIC, disseminated intravascular coagulation; TAE, transcatheter arterial embolization.

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