Clinical Characteristics Of 205 Patients With Acute Lowergastrointestinal Bleeding And Analysis Of Risk Factors

Objective: Acute lower gastrointestinal bleeding(LGIB)is a common clinical disease with an increasing incidence year by year.about 80-85% of patients with LGIB heal spontaneously,but in critical cases severe anemia,hypovolemic shock and even death can occur,and there is a high risk of rebleeding within a year.Even with medical or surgical treatment,the mortality of acute ALGIB can reach 2-4%.Therefore,early screening of critical patients and timely and effective treatment is very important for the prognosis of patients.Das proposed eight risk factors associated with severe LGIB,which were cumbersome to use because they involved Charlson weighted scores;The Oakland score system was good at predicting rebleeding during hospitalization,the need for blood transfusion,and the ability to control bleeding,but poor at estimating initial bleeding;The "BLEED" standard,developed by Kollef,considers rebleed to be a sign of instability and an indication of transfer to ICU,but lacks a specific evaluation index.Currently,there are no relevant guidelines for assessing the severity of acute lower gastrointestinal bleeding in China.this topic through acute LGIB cases in our hospital were retrospectively analyzed,and analyzes the causes and screening high correlation with the severity of disease risk factors to guide clinical diagnosis and treatment.Methods: Retrospectively collected 2016.1-2020.5 a total of 205 patients with acute lower gastrointestinal bleeding,all of the patients by the digital rectal,colonoscopy and laboratory examination clear etiology,the Strate serious LGIB screen out the definition of acute severe gastrointestinal bleeding and gastrointestinal bleeding under mild patients,by comparing the patient’s age,gender,medication history,onset time,history of syncope,fever,abdominal pain,bowel habits,weight,vital signs(blood pressure,heart rate,body temperature and respiratory frequency)and clinical data,to understand the clinical features of acute lower gastrointestinal bleeding,To screen the risk factors of acute severe lower gastrointestinal bleeding.In this paper,SPSS 21.0 software was used for statistical analysis of the data.The number of cases(%)was used to represent the counting data,and the chi-square test was used for comparison between groups.The influencing factors were analyzed by binary logistic regression.The six significant variables of univariate analysis were taken as independent variables,and the occurrence of severe gastrointestinal bleeding was taken as dependent variables,and binary logistic regression analysis was conducted.Results: A total of 1021 cases of lower gastrointestinal bleeding were collected in this study,and 205 cases were included after chronic lower gastrointestinal bleeding was excluded.Among them,there were 116 males and 89 females.134 elderly patients and71 non-elderly patients;There were 161 patients with mild disease and 44 patients with severe hemorrhage.The causes of acute lower gastrointestinal bleeding include hemorrhoids,diverticulum bleeding,colonic ulcer,tumor,anal fissure,postoperative colonic polyp,ischemic enteritis,etc.,in which the most common cases of mild bleeding were ischemic enteritis,tumor and hemorrhoids,accounting for 38.5%,10.56% and 10.56% of the patients with mild bleeding.Severe bleeding was most common in patients with tumors,accounting for 70.45% of severe bleeding,followed by diverticulum bleeding,accounting for 9.10%.Univariate analysis showed that age older than 60 years old,history of aspirin use,abdominal pain,symptoms of syncope,hemoglobin below 100g/L,albumin below 38g/L were high risk factors for severe lower GI bleeding.Six variables that were significant in univariate analysis were used as independent variables,and the occurrence of severe gastrointestinal bleeding was used as dependent variable.A binary logistic regression analysis showed that aspirin use,syncopal symptoms,hemoglobin below 100mg/d L and albumin below 38g/L were four independent risk factors for severe lower gastrointestinal bleeding.Conclusions:Ischemic enteritis,tumors and hemorrhoids were the most common causes of acute lower gastrointestinal bleeding,and severe bleeding was more common in patients with tumors.Aspirin administration,syncopal symptoms,hemoglobin below100g/L,and albumin below 38g/L may be four independent risk factors for severe lower GI bleeding.