Análisis multivariante del riesgo de recidiva hemorrágica en la úlcera gastroduodenal. Estudio de una serie prospectiva

AIM: To construct a model to enable calculation of rebleeding risk in patients admitted to a hospital emergency department with upper gastrointestinal bleeding secondary to a gastric or duodenal ulcer. METHODS: We analyzed 317 patients admitted during a 13-month period with an episode of upper gastrointestinal bleeding secondary to a gastroduodenal ulcer. The patients were followed-up for 30 days after discharge. Uni- and multivariate analysis of the clinical and endoscopic variables was performed on variables that could be associated with an increased risk of rebleeding. RESULTS: In the univariate analysis the following variables were significantly associated with an increased risk of rebleeding: the presence of blood in the endoscopically examined tract (p 2 cm (p < 0.004). Independent risk variables identified by multivariate logistic regression analysis were low cardiac output, the presence of blood in the endoscopically examined tract, size of the ulcer, and type of ulcer base. CONCLUSION: Patients with a clean ulcer base, smaller than 2 cm, without blood in the endoscopically examined tract and with stable hemodynamics were at very low risk of rebleeding and could be discharged directly from the emergency room.