Background: The aim of this study was to determine predictive factors of early mortality and early rebleeding (≤30 days) following transarterial embolization (TAE) for treatment of acute gastrointestinal bleeding. Methods: All consecutive patients admitted for acute gastrointestinal bleeding to the interventional radiology department in a tertiary center between January 2012 and January 2022 were included. Exclusion criteria were patients: (1) aged < 18-year-old, (2) referred to the operation room without TAE, (3) treated for hemobilia, (4) with mesenteric hematoma, (5) lost to follow-up within 30 days after the procedure. We evaluated pre and per-procedure clinical data, biological data, outcomes, and complications. Results: Sixty-eight patients were included: 55 (80.9%) experienced upper gastrointestinal bleeding and 13 (19.1%) lower gastrointestinal bleeding. Median age was 69 (61–74) years. There were 49 (72%) males. Median hemoglobin was 7.25 (6.1–8.3) g/dL. There were 30 (50%) ulcers. Coils were used in 46 (67.6%) procedures. Early mortality was 15 (22.1%) and early rebleeding was 17 (25%). In multivariate analysis, hyperlactatemia (≥2 mmol/L) were predictive of early mortality (≤30 days). A high number of red blood cells units was associated with early rebleeding. Conclusion: This study identified some predictive factors of 30-day mortality and early rebleeding following TAE. This will assist in patient selection and may help improve the management of gastrointestinal bleeding.
背景:本研究旨在确定经动脉栓塞(TAE)治疗急性消化道出血后早期死亡率和早期再出血(≤30 天)的预测因素。研究方法纳入2012年1月至2022年1月期间因急性消化道出血入住某三级中心介入放射科的所有连续患者。排除标准为患者:(1)年龄在18岁以下;(2)未经TAE转入手术室;(3)因血友病接受治疗;(4)有肠系膜血肿;(5)术后30天内失去随访。我们评估了手术前和手术中的临床数据、生物学数据、结果和并发症。结果:共纳入 68 例患者:55人(80.9%)出现上消化道出血,13人(19.1%)出现下消化道出血。中位年龄为 69(61-74)岁。男性 49 人(72%)。血红蛋白中位数为 7.25 (6.1-8.3) g/dL。有 30 个(50%)溃疡。46例(67.6%)手术中使用了线圈。早期死亡率为 15 例(22.1%),早期再出血为 17 例(25%)。在多变量分析中,高乳酸血症(≥2 mmol/L)可预测早期死亡率(≤30 天)。红细胞单位数多与早期再出血有关。结论本研究确定了 TAE 术后 30 天死亡率和早期再出血的一些预测因素。这将有助于选择患者,并有助于改善消化道出血的管理。