CardioVascular and Interventional Radiology

, Volume 30, Issue 5, pp 861–865 | Cite as

Shock Index Correlates with Extravasation on Angiographs of Gastrointestinal Hemorrhage: A Logistics Regression Analysis

  • Yutaka Nakasone
  • Osamu Ikeda
  • Yasuyuki Yamashita
  • Kouichi Kudoh
  • Yoshinori Shigematsu
  • Kazunori Harada
Clinical Investigation

Abstract

We applied multivariate analysis to the clinical findings in patients with acute gastrointestinal (GI) hemorrhage and compared the relationship between these findings and angiographic evidence of extravasation. Our study population consisted of 46 patients with acute GI bleeding. They were divided into two groups. In group 1 we retrospectively analyzed 41 angiograms obtained in 29 patients (age range, 25–91 years; average, 71 years). Their clinical findings including the shock index (SI), diastolic blood pressure, hemoglobin, platelet counts, and age, which were quantitatively analyzed. In group 2, consisting of 17 patients (age range, 21–78 years; average, 60 years), we prospectively applied statistical analysis by a logistics regression model to their clinical findings and then assessed 21 angiograms obtained in these patients to determine whether our model was useful for predicting the presence of angiographic evidence of extravasation. On 18 of 41 (43.9%) angiograms in group 1 there was evidence of extravasation; in 3 patients it was demonstrated only by selective angiography. Factors significantly associated with angiographic visualization of extravasation were the SI and patient age. For differentiation between cases with and cases without angiographic evidence of extravasation, the maximum cutoff point was between 0.51 and 0.0.53. Of the 21 angiograms obtained in group 2, 13 (61.9%) showed evidence of extravasation; in 1 patient it was demonstrated only on selective angiograms. We found that in 90% of the cases, the prospective application of our model correctly predicted the angiographically confirmed presence or absence of extravasation. We conclude that in patients with GI hemorrhage, angiographic visualization of extravasation is associated with the pre-embolization SI. Patients with a high SI value should undergo study to facilitate optimal treatment planning.

Keywords

Gastrointestinal hemorrhage Shock index Angiography Extravasation Logistics regression analysis 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Yutaka Nakasone
    • 1
  • Osamu Ikeda
    • 1
  • Yasuyuki Yamashita
    • 1
  • Kouichi Kudoh
    • 2
  • Yoshinori Shigematsu
    • 2
  • Kazunori Harada
    • 3
  1. 1.Department of Diagnostic RadiologyKumamoto University Graduate School of Medical and Pharmaceutical SciencesKumamotoJapan
  2. 2.Department of RadiologyAmakusa Medical CenterHondoJapan
  3. 3.Department of SurgeryAmakusa Medical CenterHondoJapan

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