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Table 3 Demographic and Clinical Predictors for 60-day Mortality (Categorical Variables)

From: Risk factors for mortality among patients admitted with upper gastrointestinal bleeding at a tertiary hospital: a prospective cohort study

Factor

60-day Mortality

Relative Risk

(95% CI)

P value

Yes

No

Total

Age

  > 40 years

31 (37.3%)

52 (62.7%)

83

1.25

0.303

  ≤ 40 years

26 (29.9%)

61 (70.1%)

87

(0.82–1.91)

 

Sex

 Male

41 (33.9%)

80 (66.1%)

121

1.04

0.878

 Female

16 (32.7%)

33 (67.3%)

49

(0.65–1.67)

 

History of previous UGIB

 Yes

21 (27.6%)

55 (72.4%)

76

0.72

0.143

 No

36 (38.3%)

58 (61.7%)

94

(0.46–1.13)

 

Use of NSAIDs in previous one week

 Yes

1 (14.3%)

6 (85.7%)

7

0.42

0.426

 No

56 (34.4%)

107 (65.6%)

163

(0.07–2.58)

 

Any Comorbidity

 Yes

40 (37.7%)

66 (62.3%)

106

1.42

0.135

 No

17 (26.6%)

47 (73.4%)

64

(0.88–2.29)

 

Cardiac Disease

 Yes

6 (42.9%)

8 (57.1%)

14

1.31

0.556

 No

51 (32.7%)

105 (67.3%)

156

(0.69–2.50)

 

Renal Insufficiency

 Yes

16 (61.5%)

10 (38.5%)

26

2.16

0.001

 No

41 (28.5%)

103 (71.5%)

144

(1.45–3.22)

 

Chronic Liver Disease

 Yes

21 (28.0%)

54 (72.0%)

75

0.74

0.175

 No

36 (37.9%)

59 (62.1%)

95

(0.47–1.15)

 

Encephalopathy

 Yes

11 (78.6%)

3 (21.4%)

14

2.67

<0.001

 No

46 (29.5%)

110 (70.5%)

156

(1.85–3.84)

 

Malignancy

 Yes

9 (56.3%)

7 (43.8%)

16

1.81

0.043

 No

48 (31.2%)

106 (68.8%)

154

(1.1–2.95)

 

Hypertension

 Yes

6 (46.2%)

7 (53.8%)

13

1.42

0.364

 No

51 (32.5%)

106 (67.5%)

157

(0.76–2.67)

 

Diabetes Mellitus

 Yes

4 (80.0%)

1 (20.0%)

5

2.49

0.044

 No

53 (32.1%)

112 (67.9%)

165

(1.52–4.07)

 

HIV

 Yes

5 (71.4%)

2 (28.6%)

7

2.24

0.043

 No

52 (31.9%)

111 (68.1%)

163

(1.33–3.76)

 

Smoking

 Yes

3 (33.3%)

6 (66.7%)

9

0.99

1.000

 No

54 (33.5%)

107 (66.5%)

161

(0.39–2.57)

 

Alcohol use in previous one week

 Yes

8 (36.4%)

14 (63.6%)

22

1.10

0.763

 No

49 (33.1%)

99 (66.9%)

148

(0.60–2.00)

 

Systolic Blood Pressure

  < 110 mmHg

23 (37.1%)

39 (62.9%)

62

1.18

0.455

  ≥ 110 mmHg

34 (31.5%)

74 (68.5%)

108

(0.77–1.81)

 

Diastolic Blood Pressure

  < 60 mmHg

17 (31.5%)

37 (68.5%)

54

0.91

0.700

  ≥ 60 mmHg

40 (34.5%)

76 (65.5%)

116

(0.57–1.46)

 

Pulse Rate

  > 100 bpm

30 (38.5%)

48 (61.5%)

78

1.31

0.210

  ≤ 100 bpm

27 (29.3%)

65 (70.7%)

92

(0.86–2.00)

 

Respiratory Rate

  > 18 bpm

44 (32.6%)

91 (67.4%)

135

0.88

0.611

  ≤ 18 bpm

13 (37.1%)

22 (62.9%)

35

(0.54–1.44)

 

Arterial Oxygen Saturation

  < 92%

2 (50.0%)

2 (50.0%)

4

1.51

0.603

  ≥ 92%

55 (33.1%)

111 (66.9%)

166

(0.55–4.12)

 

White Blood Count (k/μl)

  > 11.00

26 (54.2%)

22 (45.8%)

48

2.23

<0.001

  ≤ 11.00

28 (24.3%)

87 (75.7%)

115

(1.47–3.37)

 

Hemoglobin (g/dL)

  < 10.00

45 (31.7%)

97 (68.3%)

142

0.74

0.310

  ≥ 10.00

9 (42.9%)

12 (57.1%)

21

(0.43–1.28)

 

Platelets (k/μl)

  < 140

18 (26.5%)

50 (73.5%)

68

0.69

0.115

  ≥ 140

36 (38.3%)

58 (61.7%)

94

(0.43–1.11)

 

Serum Creatinine (μmol/L)

  > 115

21 (53.8%)

18 (46.2%)

39

2.20

0.001

  ≤ 115

22 (24.4%)

68 (75.6%)

90

(1.38–3.51)

 

Serum BUN (g/dL)

  > 7.4

21 (47.7%)

23 (52.3%)

44

2.39

0.003

  ≤ 7.4

12 (20.0%)

48 (80.0%)

60

(1.32–4.32)

 

Serum ALT (U/L)

  > 55

17 (73.9%)

6 (26.1%)

23

4.19

<0.001

  ≤ 55

15 (17.6%)

70 (82.4%)

85

(2.49–7.04)

 

Serum AST (U/L)

  > 34

24 (40.7%)

35 (59.3%)

59

2.35

0.007

  ≤ 34

9 (17.3%)

43 (82.7%)

52

(1.20–4.59)

 

Serum Total Bilirubin (μmol/L)

  > 20.5

13 (50.0%)

13 (50.0%)

26

5.00

<0.001

  ≤ 20.5

5 (10.0%)

45 (90.0%)

50

(2.0–12.50)

 

Prothrombin Time (seconds)

  > 12.1

13 (46.4%)

15 (53.6%)

28

3.71

0.008

  ≤ 12.1

3 (12.5%)

21 (87.5%)

24

(1.20–11.51)

 

APTT (seconds)

  > 30.4

7 (35.0%)

13 (65.0%)

20

1.08

0.842

  ≤ 30.4

11 (32.4%)

23 (67.6%)

34

(0.50–2.34)

 

INR

  > 1.13

13 (48.1%)

14 (51.9%)

27

4.17

0.004

  ≤ 1.13

3 (11.5%)

23 (88.5%)

26

(1.34–12.97)

 

Endoscopy

 Not Done

46 (54.8%)

38 (45.2%)

84

4.28

<0.001

 Done

11 (12.8%)

75 (87.2%)

86

(2.39–7.69)

 

Endoscopy Diagnosis

 Oesophageal Varices

6 (12.2%)

43 (87.8%)

49

0.91

1.000

 Other Diagnosis

5 (13.5%)

32 (86.5%)

37

(0.30–2.74)

 

Pre-Endoscopy Rockall Score

   

1.29

 

  > 3

21 (39.6%)

32 (60.4%)

53

(0.84–1.98)

0.257

  ≤ 3

36 (30.8%)

81 (69.2%)

117

  

Post-Endoscopy Rockall Score

  > 5

8 (15.1%)

45 (84.9%)

53

1.61

0.524

  ≤ 5

3 (9.4%)

29 (90.6%)

32

(0.46–5.63)

 
  1. Mortality was also compared to different categorical variables as outlined in Table 3. A high serum total bilirubin was associated with a 5-fold increased risk of mortality (RR = 5.00, p < 0.001). Patients with a raised serum ALT level (RR = 4.19, p < 0.001), a raised INR (RR = 4.17, p = 0.004), a prolonged prothrombin time (RR = 3.71, p = 0.008) and those who did not undergo endoscopy during admission (RR = 4.28, p < 0.001) had an almost 4-fold increased risk of mortality within 60 days from admission. Other factors that were associated with a higher risk of mortality included patients with renal insufficiency (RR = 2.16, p < 0.001), encephalopathy (RR = 2.67, p < 0.001), malignancy (RR = 1.81, p = 0.043), diabetes mellitus (RR = 2.49, p = 0.044), HIV disease (RR = 2.24, p = 0.043), a raised WBC count (RR = 2.23, p < 0.001), a raised serum creatinine level (RR = 2.20, p = 0.001), a raised serum BUN level (RR = 2.39, p = 0.003), and a raised serum AST level (RR = 2.35, p = 0.007). (See Table 3)
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BMC Gastroenterology

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