Patient selection: upper and/or lower GI hemorrhage
Parameters identified as independent risk factors for mortality on multivariate analysis:
(1) ascites
(2) APACHE III score
(3) Organ System Failure Index of Rubin et al
|
Parameter
|
Findings
|
Points
|
|
ascites
|
absent
|
0
|
|
|
present
|
1
|
|
APACHE III score
|
<= 30
|
0
|
|
|
> 30
|
1
|
|
organ system failure index
|
0 or 1
|
0
|
|
|
2 to 7
|
1
|
where:
• The adjusted odds ratio for ascites was 7.1, for APACHE III score 6.2, and organ system failure index was 4.5. To simplify the analysis a single point was assigned for each parameter.
• The Organ System Failure Index has 1 point assigned for organ failure in 7 systems: renal, hepatic, pulmonary, bone marrow, neurologic, gastrointestinal, and cardiac.
total number of factors present =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk of mortality increases with the number of parameters.
