Initial management for acute lower gastrointestinal bleeding

Table 1 Risk factors and odds ratios for various outcomes according to 11 studies[7,8,20-28]

	Severe/recurrent bleeding	In-hospital complications3	Adverse outcomes4	Mortality
Patient characteristic
Older age	2.31	-	4.21	4.92
Male sex	6	-	-	1.5-1.6
Lower body mass index	-	-	-	2.0
Smoking	-	-	0.5	-
Comorbidities
Charlson index > 2 or ≥ 2	1.7-1.9	-	-	3.0
Unstable comorbid diseases	-	2.9	-	-
Congestive heart failure	-	-	-	1.5
Cardiovascular disease	6	-	-	-
Dementia	6	-	-	5.2
Metastatic cancer	-	-	-	5.0
Chronic kidney disease	-	-	-	1.8-2.2
Liver disease	-	-	-	1.9
Chronic pulmonary disease	-	-	-	1.6
History of colonic diverticulosis and/or angiodysplasia	6	-	-	6
Presenting symptom
Syncope / altered mental status	2.5-3.3	2.0	-	6
No diarrhea	2.2	-	-	-
No abdominal tenderness	2.4-3.0	-	-	-
Ongoing bleeding	-	3.1	-	-
Bleeding in the first 4 h	2.3	-	-	-
Medication
NSAIDs (non-aspirin)1	2.5	-	-	1.5
Aspirin	1.9-2.1	-	-	-
Antiplatelet drugs (non-aspirin)	2.0	-	-	-
Anticoagulants	-	-	-	1.5
Physical examination
Blood pressure ≤ 100 or ≤ 115 mmHg	2.3-3.5	3.0	-	6
Heart rate ≥ 100/min	3.7	-	-	-
Abnormal vital signs after 1 h	4.3	-	-	-
Abnormal hemodynamic parameters	-	-	2.1	-
Gross blood on rectal examination	3.5-3.9	-	-	6
Laboratory data
Hemoglobin < 10 g/dL	3.6	-	-	-
Albumin < 3.0 or < 3.8 g/dL	2.0-2.9	-	-	2.9
Creatinine > 150 or > 133 µmol/L	6	-	10.3	6
Hematocrit < 35% or < 30%	4.7-6.3	-	-	6
Prothrombin time > 1.2 times control	-	2.0	-	-
Clinical course
Rebleeding	-	-	1.9	-
Intestinal ischemia	-	-	-	3.5
Coagulation defects	-	-	-	2.3
Hypovolemia	-	-	-	2.2
Blood transfusion	-	-	-	1.6-2.8
Need for intervention5	-	-	-	2.3-2.4
In-hospital onset LGIB	-	-	-	2.4

¹Age > 60 years;

²Age > 70 years;

³Either surgery, intensive care unit admission, or mortality;

⁴Either rebleeding, surgery, or mortality;

⁵Interventional radiology or surgery;

⁶The variables were identified as risk factors, but odds ratios of these were not described. NSAIDs: Non-steroidal anti-inflammatory drugs.