Facteurs prédictifs de défaillance d’organes chez les patients admis en réanimation pour hémorragie digestive aiguë |
| |
Authors: | Y Puymirat M Hachouf G Doassans-Cazaban F Poullenot L Lefévre S Winnock A Ouattara |
| |
Institution: | 1. Service d’anesthésie-réanimation II, hôpital du Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33000 Bordeaux, France;2. U1034, adaptation cardiovasculaire à l’ischémie, université de Bordeaux, 33000 Bordeaux, France;3. Service hépato-gastroentérologie et oncologie digestive, CHU de Bordeaux, 33000 Bordeaux, France;4. Inserm, U1034, adaptation cardiovasculaire à l’ischémie, 33600 Bordeaux, France |
| |
Abstract: | IntroductionGastrointestinal hemorrhage is an emergency requiring usually an admission in intensive care unit (ICU), which may prove abusive secondarily. The aim of this study was to identify predictive risk factors of organ failure in patients admitted for GH in our ICU.DesignRetrospective and observationalMethods and measurementsBetween January 2008 and December 2011, all patients admitted in our ICU for gastrointestinal hemorrhage were consecutively included. The primary endpoint was the occurrence of at least an organ failure. We realized an univariate analysis then a backward regression to identify independent risk factors associated with the occurrence of at least one organ failure during the ICU hospitalization.ResultsDuring this period study, 441 consecutive patients with a mean age of 67 ± 15 years were included. The median ICU length of stay was of 4 (3–7) days and 116 (26% IC95%: 22–30]) patients presented at least one organ failure. The multivariate analysis identified predictive risk factors of organ failure: history of cirrhosis (OR = 3.5 IC95%: 1.9–6.7], P < 0.001) and an increase in troponin at the admission above the 99th percentile (OR = 3.1 IC95%: 1.8–5.5], P < 0.001).ConclusionOur results confirmed that a large proportion of patients admitted in ICU for the primary diagnosis of gastrointestinal hemorrhage developed any organ failure. The history of cirrhosis and the systemic consequences of the hemorrhagic syndrome as myocardial damage represents important risk factors of morbidity and mortality and thus should be considered during the management. |
| |
Keywords: | Hé morragie digestive Dé faillance d&rsquo organe Souffrance myocardique |
本文献已被 ScienceDirect 等数据库收录! |
|