Predictors of active extravasation and complications after conventional angiography for acute intraabdominal bleeding Journal Article
| Authors: | Haber, Z. M.; Charles, H.; Erinjeri, J. P.; Deipolyi, A. R. |
| Article Title: | Predictors of active extravasation and complications after conventional angiography for acute intraabdominal bleeding |
| Abstract: | Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study's purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013-June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (Delta Hct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. Delta Hct was the only independent predictor of extravasation (p = 0.017), with larger Delta Hct (-17%) in patients with versus those without extravasation (-1%) (p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor (p = 0.03); 67% of patients with GFR <30, 29% of patients with GFR 30-60, and 8% of patients with GFR >60 developed CIN. For patients with intraabdominal bleeding, greater Delta Hct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment. |
| Keywords: | gastrointestinal hemorrhage; outcomes; angiography; hematocrit; risk-factors; localization; metaanalysis; embolization; hemorrhage; acute kidney injury; renal-failure; contrast-induced nephropathy; gfr; row helical ct |
| Journal Title: | Journal of Clinical Medicine |
| Volume: | 6 |
| Issue: | 4 |
| ISSN: | 2077-0383 |
| Publisher: | MDPI |
| Date Published: | 2017-04-01 |
| Start Page: | 47 |
| Language: | English |
| ACCESSION: | WOS:000403461100012 |
| DOI: | 10.3390/jcm6040047 |
| PROVIDER: | wos |
| PMCID: | PMC5406779 |
| PUBMED: | 28420210 |
| Notes: | Article -- Source: Wos |
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