Predictive factors of recurrent bleeding in Mallory-Weiss syndrome.

Jae Woo Kim, Hyunsoo Kim, Jong Won Byun, Chan Sik Won, Myeong Gwan Jee, Yong Soon Park, Soonkoo Baik, Sang Ok Kwon, DongKi Lee

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Abstract

BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.

Original languageEnglish
Pages (from-to)447-454
Number of pages8
JournalThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume46
Issue number6
Publication statusPublished - 2005 Jan 1

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Mallory-Weiss Syndrome
Hemorrhage
Shock
Critical Care
Platelet Count
Liver Cirrhosis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Jae Woo ; Kim, Hyunsoo ; Byun, Jong Won ; Won, Chan Sik ; Jee, Myeong Gwan ; Park, Yong Soon ; Baik, Soonkoo ; Kwon, Sang Ok ; Lee, DongKi. / Predictive factors of recurrent bleeding in Mallory-Weiss syndrome. In: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi. 2005 ; Vol. 46, No. 6. pp. 447-454.
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Predictive factors of recurrent bleeding in Mallory-Weiss syndrome. / Kim, Jae Woo; Kim, Hyunsoo; Byun, Jong Won; Won, Chan Sik; Jee, Myeong Gwan; Park, Yong Soon; Baik, Soonkoo; Kwon, Sang Ok; Lee, DongKi.

In: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, Vol. 46, No. 6, 01.01.2005, p. 447-454.

Research output: Contribution to journalArticle

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AU - Kim, Jae Woo

AU - Kim, Hyunsoo

AU - Byun, Jong Won

AU - Won, Chan Sik

AU - Jee, Myeong Gwan

AU - Park, Yong Soon

AU - Baik, Soonkoo

AU - Kwon, Sang Ok

AU - Lee, DongKi

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N2 - BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.

AB - BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.

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