Mortality Risk Factors in Patients with Upper Gastrointestinal Bleeding in a Medical Intensive Care Unit

Abstract

Purpose: The aim of this study was to evaluate the general clinical characteristics of acute gastrointestinal system (GIS) bleeding patients who were followed-up in the intensive care unit (ICU) and the risk factors for mortality. Materials and Methods: The GIS bleeding patients followed up in a medical ICU between October 2016 and March 2019 were included. Patients were evaluated for demographic, clinical and laboratory data (on admission and after 24-hours) and compared according to the mortality status (surviving vs. non-surviving). Results: A total of 64 patients (37 males and 27 females) with a median age of 73.5 (31-93) years were evaluated. All patients had upper GIS bleeding and the mortality rate was 29.7%. There was no difference between the mortality groups for gender, age and chronic co-morbid diseases except malignancy. High BUN, creatinine, INR, and lactate levels after 24 hours were significantly associated with mortality. All patients had a diagnosis of upper GIS bleeding. In the logistic regression analysis, the presence of acute respiratory insufficiency, long hospital stays before ICU, high SOFA score and high lactate levels after 24 hours were the independent predictors of ICU mortality). Conclusion: In this study, we found that high levels of BUN, creatinine, INR, and lactate levels in the first 24 hours of follow-up, rather than the values on admission to ICU, were associated with increased mortality. Therefore, we suggest that close monitoring and rapid normalization of these values with appropriate treatments is important.