Circulating stem/progenitor cell biomarkers and prognosis in critically ill patients with gastrointestinal bleeding

Table 1 Baseline characteristics (grouped by 28 days outcome), n (%)/mean ± SD/median (quartile)

Indices	Survival group (n = 111)	Death group (n = 29)	Statistical values	P value
Age (years)	61.83 ± 13.73	61.55 ± 10.31	t = 0.120	0.905
Sex
Male	62 (55.86)	16 (55.17)	χ2 = 0.000	1.000
Female	49 (44.14)	13 (44.83)
Variceal hemorrhage	35 (31.53)	13 (44.83)	χ2 = 1.741	0.261
Liver cirrhosis	27 (24.32)	18 (62.07)	χ2 = 15.830	< 0.001
CKD	23 (20.72)	6 (20.69)	χ2 = 0.000	1.000
Coronary heart disease	32 (28.83)	6 (20.69)	χ2 = 0.471	0.520
History of antithrombotic therapy	36 (32.43)	10 (34.48)	χ2 = 0.000	1.000
SOFA (points)	7.96 ± 3.00	10.21 ± 2.15	t = -4.123	0.001
APACHE II (points)	23.50 ± 6.71	24.47 ± 6.11	t = -0.732	0.466
AIMS65	3.00 (2.00, 3.00)	4.00 (3.00, 4.00)	Z = -2.652	0.008
Hb (g/L)	72.52 ± 17.79	72.77 ± 20.94	t = -0.058	0.954
PLT (109/L)	137.59 ± 58.87	111.07 ± 71.54	t = 1.823	0.073
INR	1.56 (1.24, 1.90)	1.58 (1.22, 1.92)	Z = -0.128	0.898
Alb (g/L)	29.03 ± 6.17	28.59 ± 6.46	t = 0.341	0.734
Lactic acid (mmol/L)	2.95 (2.28, 3.55)	4.20 (3.05, 5.35)	Z = -2.981	0.003
CD34+ cells (/μL)	2.69 (1.87, 3.92)	2.92 (2.06, 4.12)	Z = -0.238	0.813
lnEPC (CD34+KDR+)	1.35 (1.08, 1.60)	0.85 (0.65, 1.15)	t = 4.875	< 0.001
EPC (CD34+CD133+KDR+) (/μL)	0.23 (0.09, 0.43)	0.21 (0.12, 0.38)	Z = -0.278	0.781

CKD: Chronic kidney disease; SOFA: Sequential Organ Failure Assessment; APACHE II: Acute Physiology and Chronic Health Evaluation II; AIMS65: Albumin, international normalized ratio, mental status, systolic blood pressure, age ≥ 65 years; Hb: Hemoglobin; PLT: Platelets; INR: International normalized ratio; Alb: Albumin; EPC: Endothelial progenitor cell; KDR: Kinase insert domain receptor; lnEPC: Natural log-transformed endothelial progenitor cell count.

Table 2 Etiological distribution of hemorrhage and 28-day mortality

Etiology of hemorrhage (endoscopy/imaging)	Number of cases	Number of deaths	28-day mortality (%)
Peptic ulcer	51	7	13.7
Esophageal and gastric varices rupture	36	11	30.6
Stress mucosal lesion	20	3	15.0
Tumor associated hemorrhage	9	2	22.2
Portal hypertensive gastropathy	8	1	12.5
Vascular malformations/diverticula	7	3	42.9
Dieulafoy lesions	5	1	20.0
Gastric varices	4	1	25.0

Table 3 Comparison of outcomes and critical treatment measures, n (%)

Outcome/measures	Survival group (n = 111)	Death group (n = 29)	Statistical values	P value
7-day rebleeding rate	24 (21.62)	5 (17.24)	χ2 = 0.269	0.604
Infusion RBC (U)	5.00 (3.00, 6.00)	5.00 (4.00, 7.00)	Z = -0.501	0.616
Vasoactive drug utilization	46 (41.44)	21 (72.41)	χ2 = 8.839	0.003
Mechanical ventilation rate	36 (32.43)	19 (65.52)	χ2 = 10.552	0.001
CRRT rate	28 (25.23)	9 (31.03)	χ2 = 0.155	0.693
ICU stay (day)	6.00 (4.00, 9.00)	8.00 (5.00, 12.00)	Z = 1.556	0.031
Total hospitalization days	15.68 (12.80, 19.30)	14.82 (13.86, 20.32)	Z = -0.583	0.561
90-day mortality	31 (27.93)	12 (41.38)	χ2 = 1.732	0.241

RBC: Red blood cell; CRRT: Continuous renal replacement therapy; ICU: Intensive care unit.

Table 4 Multivariable logistic regression analysis (28-day mortality)

Variables	β	SE	OR	95%CI	P value
SOFA	0.120	0.079	1.127	0.965-1.316	0.131
Lactic acid (mmol/L)	0.034	0.171	1.035	0.740-1.447	0.841
AIMS65	0.106	0.242	1.112	0.692-1.788	0.661
Cirrhosis	0.669	0.485	1.952	0.755-5.050	0.168
lnEPC (CD34+KDR+)	-0.586	0.233	0.557	0.353-0.879	0.012

β: Regression coefficient; SE: Standard error; OR: Odds ratio; CI: Confidence interval; SOFA: Sequential Organ Failure Assessment; AIMS65: Albumin, international normalized ratio, mental status, systolic blood pressure, age ≥ 65 years; lnEPC: Natural log-transformed endothelial progenitor cell count; KDR: Kinase insert domain receptor.