[Predictive factors of organ failure in patients admitted in intensive care unit for acute gastrointestinal bleeding]

Abstract

Introduction: Gastrointestinal 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.

Design: Retrospective and observational

Methods and measurements: Between 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.

Results: During this period study, 441 consecutive patients with a mean age of 67±15years 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).

Conclusion: Our 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: Défaillance d’organe; Gastrointestinal hemorrhage; Hémorragie digestive; Myocardial injury; Organ failure; Souffrance myocardique.