XXXX management in Portugal: a multicentric prospective 1-year survey.

@entity1 @entity63 @entity7261 @entity14 @entity360
INTRODUCTION: @entity360 ( @entity360 ) is a common event, which consumes considerable @entity1 and economic resources. Its incidence is expected to rise in the coming years due to an increasing aging population. @entity1 AND METHODS: Multicentric prospective analysis of @entity1 was carried out with @entity360 in 13 Portuguese hospitals from April 2008 to May 2009, using a protocol designed by the French Association Nationale des H  pato-Gastroent  rologues des H  pitaux G  n  raux. Statistical analysis was carried out with SPSS 16.0. RESULTS: In a total of 371 hemorrhagic events in 364 @entity1 (51.4% @entity1 , mean age: 72 years), 28.4% @entity1 showed hemodynamic instability and 54.2% were under single/combined medication with antiaggregants/NSAIDs/heparin/anticoagulants; blood transfusion was administered in 34.8% of @entity1 . Sigmoidoscopy was the first endoscopic procedure performed in 61.3% of @entity1 and rectal enema was the first method of bowel preparation in 67.3% of them. Endoscopic hemostasis was performed in 22.2% of all cases with efficacy ranging from 84.6 to 96.2%. Most frequent diagnoses were @entity63 (23.7%), @entity7261 (20.8%), and @entity14 (12.4%). Surgery was needed in 8% of @entity1 , and global mortality rate was 2.2%. Risk factors for poor outcome on multivariate analysis were heparin use before bleeding (hazards ratio: 10.6; 95% confidence interval: 0.94-119.48) and in-hospital bleeding (hazards ratio: 5.6; 95% confidence interval: 1.01-19.70). CONCLUSION: @entity360 seems to occur frequently in Portugal with a low mortality rate. Previous heparin use and in-hospital bleeding are associated with worse prognosis. Our management relies on early endoscopic examinations, which are highly available, safe, and accurate. A successful endoscopic therapeutic approach was possible in one fifth of the @entity1 .
