Sa1680 Predictive Risk Factors for Postoperative Gastrointestinal Bleeding in Patients Receiving Left Ventricular Assist Devices

Abstract

Sa1679 Risk Factors of Bleeding Due to Dieulafoy’s Lesion and Prognostic Factors for Rebleeding Due to Dieulafoy’s Lesion Sang Hun Park*, Chang-Hwan Park, Sung UK. Lim, Ho-Seok Ki, Chunghwan Jun, Seon-Young Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew Chonnam National University Hospital, Gwangju, Republic of Korea Background/Aims: Dieulafoy’s lesion (DL) is a rare but important cause of upper gastrointestinal bleeding (UGIB). This study was carried out to reveal the risk factors of bleeding due to Dieulafoy’s lesion and identify prognostic factors for recurrent bleeding (RB). Patients and Methods: One hundred seventy two patients with UGIB due to DL between January 2004 and June 2013 were evaluated, retrospectively. We analyzed the demographic data, endoscopic findings, details of endoscopic therapy and recurrence of bleeding. Results: The study group consists of 115 male and 57 female patients with a mean age of 68.6 14.2 years. Fifty-seven patients received antiplatelet, anticoagulant and NSAID medication. The most common location was proximal stomach (36.6%) and the most common bleeding type was oozing (60.5%). Endoscopic therapy was successful in stopping the bleeding in 97.7%; single endoscopic treatment in 46.2% and combination treatment in 53.8%. Major risk factors were hypertention (43.6%), diabetes (32.0%), smoking (29.1%), kidney disease (22.7%), infection (20.3%), liver cirrhosis (16.9%), stroke (15.7%), viral hepatitis (14.5%), ischemic heart disease (13.4%), cancer (9.9%), congestive heart failure (8.7%), hematologic disease (6.4%), valvular heart disease (4.1%). Rebleeding occurred in 28 with mean duration of 5.9 days after initial hemostasis. There were significant differences in the distribution of kidney disease (acute kidney injury & chronic kidney disease) (15/28 vs. 25/144, pZ0.006, AORZ6.637, CI: 1.711w25.753) and infection (15/28 vs. 21/144, pZ0.001, AORZ6.421, CI:2.051w20.103) between two groups. The mean value of APTT (52.1 sec vs. 41.8 sec, p Z 0.001), creatinine (2.9vs 1.5 mg/dl, pZ0.008), and CRP (3.3vs 2.3 mg/dl, pZ0.021) were significantly higher in the RB. Mortality rate of RB was 39.3% compared to 3.5% of NRB (p!0.001). Conclusion: Kidney disease and infection were the risk factors of RB of DL. Control of underlying disease is important in the management of DL.