Elevated lactate level predicts intensive care unit admissions, endoscopies and transfusions in patients with acute gastrointestinal bleeding
| Autor: | Eugene Trowers, Manish P. Shrestha, Mark Borgstrom |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Colonoscopy Logistic regression law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine ICU admissions Medicine endoscopy Original Research venous lactate medicine.diagnostic_test Clinical and Experimental Gastroenterology business.industry Acute gastrointestinal bleeding Gastroenterology Odds ratio Triage Intensive care unit Confidence interval Endoscopy 030220 oncology & carcinogenesis acute gastrointestinal bleeding 030211 gastroenterology & hepatology business |
| Zdroj: | Clinical and Experimental Gastroenterology |
| ISSN: | 1178-7023 |
| Popis: | Manish P Shrestha,1 Mark Borgstrom,2 Eugene Abraham Trowers3 1Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA; 2Research Computing Group of University Information Technology Services, University of Arizona, Tucson, AZ, USA; 3Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, USA Background and aims: Initial clinical management decision in patients with acute gastrointestinal bleeding (GIB) is often based on identifying high- and low-risk patients. Little is known about the role of lactate measurement in the triage of patients with acute GIB. We intended to assess if lactate on presentation is predictive of need for intervention in patients with acute GIB. Patients and methods: We performed a single-center, retrospective, cross-sectional study including patients ≥18years old presenting to emergency with acute GIB between January 2014 and December 2014. Intensive care unit (ICU) admission, inpatient endoscopy (upper endoscopy and/or colonoscopy), and packed red blood cell (PRBC) transfusion were assessed as outcomes. Analyses included univariate and multivariate logistic regression analyses. Results: Of 1,237 patients with acute GIB, 468 (37.8%) had venous lactate on presentation. Of these patients, 165 (35.2%) had an elevated lactate level (>2.0mmol/L). Patients with an elevated lactate level were more likely to be admitted to ICU than patients with a normal lactate level (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI] 1.74–5.01; p |
| Databáze: | OpenAIRE |
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