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Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

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...

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Autores principales: Haber, Zachary M., Charles, Hearns W., Erinjeri, Joseph P., Deipolyi, Amy R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406779/
https://www.ncbi.nlm.nih.gov/pubmed/28420210
http://dx.doi.org/10.3390/jcm6040047
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author Haber, Zachary M.
Charles, Hearns W.
Erinjeri, Joseph P.
Deipolyi, Amy R.
author_facet Haber, Zachary M.
Charles, Hearns W.
Erinjeri, Joseph P.
Deipolyi, Amy R.
author_sort Haber, Zachary M.
collection PubMed
description 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 (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−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 ΔHct 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.
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spelling pubmed-54067792017-04-27 Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding Haber, Zachary M. Charles, Hearns W. Erinjeri, Joseph P. Deipolyi, Amy R. J Clin Med Article 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 (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−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 ΔHct 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. MDPI 2017-04-18 /pmc/articles/PMC5406779/ /pubmed/28420210 http://dx.doi.org/10.3390/jcm6040047 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Haber, Zachary M.
Charles, Hearns W.
Erinjeri, Joseph P.
Deipolyi, Amy R.
Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title_full Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title_fullStr Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title_full_unstemmed Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title_short Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding
title_sort predictors of active extravasation and complications after conventional angiography for acute intraabdominal bleeding
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406779/
https://www.ncbi.nlm.nih.gov/pubmed/28420210
http://dx.doi.org/10.3390/jcm6040047
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