Clinical predictors of arterial extravasation, rebleeding and mortality following angiographic interventions in gastrointestinal bleeding

Prasoon Mohan, John J. Manov, Alexander Diaz-Bode, Sree Venkat, Michael Langston, Akash Naidu, Rayna Howse, Govindarajan Narayanan

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background & Aims: The aim of this study was to identify clinical and imaging predictors of arterial extravasation, post embolization rebleeding and 30-day mortality in gastrointestinal (GI) bleeding. Method: This retrospective study included 114 patients who underwent angiography for upper or lower GI bleeding. Multivariate logistic regression was used to identify clinical and imaging predictors. Results: Angiography demonstrated arterial extravasation in 22 patients (19%) and embolization was performed in 48 (42%) patients including prophylactic embolization in 26 (56%). Fall in hemoglobin level from baseline was an independent predictor of arterial extravasation with 65% increased odds for every unit drop (OR 1.65, 95%CI 1.13-2.40, p=0.01). Age <60 years was a negative predictor of rebleed within 30-days (OR 0.94, 95%CI 0.89-1.00, p=0.04). Patients with a history of malignancy were more likely to rebleed (OR 4.4, 95%CI 1.06-18.36, p=0.04). Hemodynamic instability prior to angiography (OR 13.22, 95%CI 1.65-106.07, p=0.02), history of malignancy (OR 1.36, 95%CI 1.49-10.49, p=0.01), number of units of platelets transfused (OR 1.42, 95%CI 1.02-1.97, p=0.04) and rebleed after angiography (OR 46.8, 95%CI 4.80-456.14, p<0.01) were predictors of 30-day mortality. Prophylactic embolization was not a predictor of rebleed or 30-day mortality. Conclusions: This paper identified important clinical predictors of arterial extravasation, rebleed and 30-day mortality in GI bleedings, which will assist in patient selection and help to improve the overall angiographic management of GI bleeding.

Original languageEnglish (US)
Pages (from-to)221-226
Number of pages6
JournalJournal of Gastrointestinal and Liver Diseases
Volume27
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Embolization
  • Lower gastrointestinal bleeding
  • Mesenteric angiography
  • Upper gastrointestinal bleeding

ASJC Scopus subject areas

  • Gastroenterology

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