Patient selection: cirrhotic patient with upper GI bleeding
Parameters:
(1) age in years
(2) carcinoma of the digestive tract
(3) inpatient vs outpatient
(4) hematemesis
(5) therapy with corticosteroids
(6) hypoprothrombinemia
|
Parameter
|
Finding
|
OR
|
|
age in years
|
<= 60 years
|
1
|
|
|
> 60 years
|
1.8
|
|
carcinoma of digestive tract
|
absent
|
1
|
|
|
present
|
4.5
|
|
hospital status
|
outpatient
|
1
|
|
|
inpatient
|
3.6
|
|
hematemesis
|
absent
|
1
|
|
|
present
|
2.7
|
|
therapy with corticosteroids
|
no
|
1
|
|
|
yes
|
3.8
|
|
prothrombin level
|
>= 40%
|
1
|
|
|
< 40%
|
7.9
|
where:
• Prothrombin activity is used in Europe. Usually this is done by correlating a coagulation test with various dilutions of prothrombin. Alternatively the factor can be measured.
• Carcinoma of the digestive tract include hepatocellular and pancreatic carcinomas.
cumulative odds ratio of mortality =
= PRODUCT(OR for all 6 parameters)
Interpretation:
• minimum cumulative odds ratio: 1
• maximum cumulative odds ratio: 2,363
• The higher the number the greater the risk for mortality.
