Prognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding

Prognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding Mihran Khdhir, Youssef Ghosn, Yara Jabbour, David Dushfunian, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7390228/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Rational and Objective: This study aimed to identify predictors of 28-day mortality in patients with suspected active bleeding undergoing Computed Tomography Angiography (CTA). Materials and Methods: Retrospective analysis of patients who underwent multi-phasic CTA for suspected active bleeding at a major medical center between January 2019 and November 2021 was performed. The study assessed the association of demographic variables, laboratory data, CTA findings, and interventions performed with 28-day mortality. Statistical analyses included chi-square tests, t-tests, Cox Proportional Hazards Model, and Kaplan-Meier survival curves. Results: A total of 174 patients were analyzed, showing an 18% (n=32) mortality rate within the 28-day period. Cox regression analysis showed that substantial contrast extravasation (HR: 2.49, 95% CI: 1.17 - 5.29, p = 0.018), anticoagulation therapy (HR: 2.46, 95% CI: 1.18 - 5.11, p = 0.016), mean INR (HR: 3.73, 95% CI: 1.78 - 7.82, p < 0.001), and vasopressors use (HR: 4.91, 95% CI: 2.31 - 10.41, p < 0.001) were independently associated with an increased risk of mortality. The type of intervention did not significantly affect mortality rates. Conclusion: Substantial contrast extravasation was the only imaging feature independently associated with increased mortality in patients with suspected active bleeding. Nuclear Medicine & Medical Imaging Active bleeding mortality Figures Figure 1 Figure 2 Figure 3 Figure 4 Highlights 1- Substantial contrast extravasation on CTA was independently associated with 28-day mortality in patients with suspected active bleeding. 2- Anticoagulation, elevated INR, and vasopressor use were also independently associated with increased mortality. 3- The type of intervention was not associated with mortality. Introduction The critical role of Computed Tomography Angiography (CTA) and Interventional Radiology (IR) in diagnosing and managing active bleeding cannot be overstated. CTA ability to identify a bleed, delineate its extent, and detect active extravasation sites help guiding the selection of appropriate interventional strategies [ 1 – 5 ]. However, the prognosis of patients with suspected active bleeding remains an interplay of various factors with multiple proposed management strategies that generally depend on the suspected etiology, hemodynamic stability, and coagulation profile [ 6 – 12 ]. The integration of CTA findings, such as hematoma size and presence of active contrast extravasation, alongside the clinical data and types of interventions received, could provide valuable insights into the prognosis of patients presenting with suspected active bleed. This study aims to evaluate the predictors of 28-day mortality in such patients, focusing on demographic variables, laboratory data, imaging findings, and the type of intervention performed. The aim is to critically evaluate the role of imaging and interventions while providing a comprehensive analysis that could inform future clinical practices and guidelines. Materials and Methods sections Study Design and Population This was a retrospective study approved by the institutional review board (IRB), which waived the requirement for informed consent. The picture archiving and communication system (PACS) was accessed to identify patients who underwent multi-phasic CT angiography (CTA) of the neck, chest, abdomen and/or pelvis, and extremities for suspected active bleed between January 2019 and November 2021. PACS was searched for cases with words “bleed”, “hemorrhage” and/or “hematoma” within the clinical indication section of CTA reports. Search was limited to the emergency department and inpatient cases. Patients were excluded if the CT protocol did not include non-enhanced, arterial, and proto-venous phases. Clinical and laboratory data were extracted from electronic medical records, including age, sex, body mass index (BMI), comorbidities, medication use, laboratory findings when active bleed was suspected, and the suspected bleeding etiology. Information on the type of interventions received, and mortality outcomes within 28 days of the CTA were also collected. CTA protocol CTA was performed on one of three CT scanners: 256 slice, IQon Spectral CT, Philips Healthcare; 256 slice, Brilliance iCT, Philips Healthcare; or 128 slice, Incisive, Philips Healthcare. Following acquisition of a non-contrast CT, low-osmolar iodinated contrast (350 mg/ml Iodine) was administered by power injector intravenously at 4 ml/ sec. Arterial-phase imaging was triggered using bolus tracking. The portal/venous phase was acquired 80s to 100s. All CT scans were reconstructed and archived with contiguous thin sections of 1 mm thickness and routine acquisition and archiving of coronal and sagittal reconstructions. CTA images interpretation CTA images were reviewed by an interventional radiologist, a body imaging radiologist, and a general radiologist independently (with 10 years, 7 years, and 20 years of experience respectively). The readers had no access to other images or clinical information. CT images were initially reviewed to identify the region of interest (neck, chest, abdomen, pelvis, extremities). Each radiologist independently reviewed CTA images and assessed the images to diagnose whether there was a hematoma, the hematoma size (small vs large), the presence of contrast extravasation, whether the extravasation is contained (pseudoaneurysm) or free, and the extravasation volume [mild (Fig. 1 ) vs substantial (Fig. 2 )]. No quantitative measurement of the extravasation volume or hematoma size was performed. As all imaging variables were binary, consensus was determined by a unanimous (3 votes) or majority (2 votes) agreement among the readers for each finding. Statistical Analysis Associations between various factors and mortality within 28 days were analyzed using chi-square tests for categorical variables and independent t-tests for continuous variables. Inter-rater reliability analysis was performed involving three raters to assess the presence of hematoma on CTA, hematoma size, presence of contrast extravasation, and degree of extravasation, employing Fleiss' kappa to measure agreement beyond chance. Kaplan-Meier curves were used to visualize the probability of survival for different imaging variables and used Log Rank (Mantel-Cox) Test Statistics for comparative analysis. Stepwise Multivariate Cox regression analysis of the significant variables was performed to identify independent predictors of mortality. Statistical analysis was performed using SPSS version 17.0. A p-value of less than 0.05 was considered statistically significant. Results Demographic and comorbidities A total of 174 cases were analyzed, with an 82% survival rate (n = 142) and an 18% mortality rate (n = 32) within the 28-day period following CT angiography (Table 1 ). Table 1 Association between age, sex, comorbidities, and medication with death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography. Characteristics Total individuals n (%) Alive 28 days after CT angiography Deceased within 28 days after CT angiography P value Total (%) 174 (100%) 142 (100%) 32 (100%) Mean Age (± SD) (yrs) 57.2 ± 22.2 54.9 ± 22.2 67.7 ± 19.0 0.002* Age group, N (%) (yrs) ≤ 18 11(6.3) 9(6.3) 2 (6.3) 0.005* 19–45 42 (24.1) 41(28.9) 1 (3.1) 46–65 42 (24.1) 34 (23.9) 8 (25.0) ≥ 66 79 (45.4) 58 (40.8) 21 (65.6) Mean BMI (+- SD) (kg/m2) 26.3 ± 6.4 25.8 ± 5.9 28.3 ± 8.1 0.144 BMI group (kg/m2), N(%) < 18.5 11 (71) 9 (7.0) 2 (7.1) 0.023* 18.5–29.9 108 (69.2) 94 (73.4) 14 (50.0) ≥ 30 37 (23.7) 25 (19.5) 12 (42.9) Sex, N (%) Male 115 (66.1) 98 (69.0) 17 (53.1) 0.086 Female 59 (33.9) 44 (31.0) 15 (46.9) Any comorbidity, N (%) No 53 (30.5) 49 (34.5) 4 (12.5) 0.015* Yes 121 (69.5) 93 (65.5) 28 (87.5) Comorbidities, Mean (+- SD) 1.7 ± 1.5 1.6 ± 1.5 2.1 ± 1.5 0.092 Malignancy, N (%) No 117 (67.2) 101 (71.1) 16 (50.0) 0.021* Yes 57 (32.8) 41 (28.9) 16 (50.0) Medications Anticoagulation No 120(69.0) 107 (75.4) 13 (40.6) < 0.0001* Yes 54 (31.0) 35 (24.6) 19 (59.4) Antiplatelet No 146 (83.9) 123 (86.6) 23 (71.9) 0.040* Yes 28 (16.1) 19 (13.4) 9 (28.1) Thrombolytic No 172 (98.9) 142 (100.0) 30 (93.8) 0.033* Yes 2 (1.1) 0 (0.0) 2 (6.3) NSAID No 163 (93.7) 134 (94.4) 29 (90.6) 0.427 Yes 11 (6.3) 8 (5.6) 3 (9.4) Chemotherapy drug/s No 142 (81.6) 119 (83.8) 23 (71.9) 0.116 Yes 32 (18.4) 23 (16.2) 9 (28.1) * Indicates significant p-value. Regarding age distribution, 6.3% (n = 11) of the participants were 18 years or younger, 24.1% (n = 42) were between 19 and 45 years, 24.1% (n = 42) were between 46 and 65 years, and 45.4% (n = 79) were 66 years or older. A statistically significant higher percentage of deceased patients (65.6%) fell into the oldest age group (≥ 66 years) compared to survivors (40.8%) (p = 0.005). Sex distribution showed 66.1% male and 33.9% female participants, with no significant deference in mortality (69.0% males vs. 53.1% females, p = 0.086). The mean BMI was 26.26 kg/m 2 (SD = 6.42), with no significant difference between survivors and deceased individuals (p = 0.144). However, there was a significant difference in mortality with the ≥ 30 kg/m 2 BMI groups showing the highest rate of death (19.5% alive vs. 42.9% deceased, p = 0.023). The presence of any comorbidity was associated with increased mortality (87.5% in deceased vs. 65.5% in survivors, p = 0.015). The number of comorbidities showed a trend towards higher mortality, but this was not statistically significant (p = 0.092). No significant association was observed between mortality and hypertension, diabetes, heart disease, CKD, dialysis, peripheral arterial disease, cerebrovascular disease, chronic lung disease, cirrhosis, or COVID-19 status (supplemental material Table 1 ). However, individuals with malignancy had a significantly higher mortality rate (50.0% of decreased vs. 28.9% of survivors, p = 0.021). The use of anticoagulation medications was significantly associated with mortality, with 59.4% of deceased patients having received anticoagulants compared to 24.6% of survivors (p < 0.001). Similarly, the use of antiplatelet medications was more common among deceased patients (28.1%) than survivors (13.4%), and this difference was significant (p = 0.040). Additionally, thrombolytic therapy was only used by deceased patients (6.3%) (p = 0.033). Laboratory findings The association between laboratory findings at presentation and death within 28 days of presentation are shown in Table 2 (categorical variables) and supplementary material table 2 (contentious variables). Table 2 Association between abnormal lab findings (categorical) and bleeding location at presentation and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography. Variable Total individuals n (%) Alive 28 days after CT angiography n (%) Deceased within 28 days after CT angiography n (%) P value Total N (%) 174 142 (100%) 32 (100%) Hemoglobin baseline (g/dl) ≥ 12 43 (28.9) 37(30.6) 6(21.4) 0.362 8-11.9 97 (65.1) 78(64.5) 19(67.9) < 8 8 (6.0) 6(5.0) 3(10.7) Hemoglobin at presentation (g/dl) ≥ 12 23 (13.2) 22(15.5) 1(3.1) 0.017* 8-11.9 78 (44.8) 67(47.2) 11(34.4) < 8 73 (42.0) 53(37.3) 20(62.5) Hemoglobin drop (g/dl) < 2 77 (51.7) 68(56.2) 9(32.1) 0.022* ≥ 2 72 (48.3) 53(43.8) 19(67.9) WBC 11000 94 (54.0) 72(50.7) 22(68.8) Creatinine (mg/dl) > 1.2 42 (24.1) 33(23.2) 9(28.1) 0.560 ≤ 1.2 132 (75.9) 109(76.8) 23(71.9) BUN (mg/dl) > 25 65 (37.8) 45(31.9) 20(64.5) 0.001* ≤ 25 107 (62.2) 96(68.1) 11(35.5) Total Bilirubin (mg/dl) > 3 10 (11.0) 6(8.6) 4(19.0) 0.231 ≤ 3 81 (89.0) 64(91.4) 17(81.0) Direct bilirubin (mg/dl) > 3 5 (5.6) 3(4.3) 2(9.5) 0.331 ≤ 3 85 (94.4) 66(95.7) 19(90.5) pH 7.45 35 (30.4) 30(34.1) 5(18.5) INR ≤ 1.5 141 (85.5) 122(91.0) 19(61.3) 1.5 24 (14.5) 12(9.0) 12(38.7) Lactate (mmol/L) 4 31 (30.1) 17(21.3) 14(60.9) D dimer (ng/ml) 0.013* < 1000 12 (35.3) 12(48.0) 0(0.0) ≥ 1000 22 (64.7) 13(52.0) 9(100.0) * Indicates significant p-value. Hemoglobin level showed significant associations with mortality. At presentation, 62.5% (20 out of 32) of deceased patients had hemoglobin < 8 g/dL, compared to 37.3% (53 out of 142) of survivors (p = 0.017), and a significant hemoglobin drop (≥ 2 g/dL) was observed in 59.4% of deceased patients versus 37.3% of survivors (p = 0.022). The mean hemoglobin level at presentation was lower in deceased individuals (7.4 ± 1.6) compared to survivors (9.3 ± 2.6) (p < 0.001), and the average drop in hemoglobin was significantly greater in deceased individuals (3.1 ± 1.504) versus survivors (2.0 ± 1.4) (p = 0.001). However, baseline hemoglobin ≥ 12 g/dL did not show a significant association with mortality, being present in 18.8% (6 out of 32) of deceased patients compared to 26.1% (37 out of 142) of survivors (p = 0.362). Hypotension and hypoxia at presentation were also strongly associated with mortality, with 75% of deceased patients presenting with hypotension (p 1.5) was present in 38.7% of deceased patients versus 9.0% of survivors (p < 0.001), and the mean INR was also higher among the deceased (1.9 ± 1.4; p = 0.015); similarly, mean prothrombin time (PT) was higher in deceased patients (24.4 ± 18.7; p = 0.011). Platelet count demonstrated a marginal association with mortality, with deceased individuals showing lower mean platelet counts (184,262.5 ± 122,675.9; p = 0.050). Elevated BUN was significantly associated with mortality, observed in 64.5% of deceased patients compared to 35.5% with levels ≤ 25 mg/dL (p = 0.001), and the mean BUN was higher among deceased individuals (40.2 ± 35.7) compared to survivors (26.45 ± 24.3) (p = 0.010). Albumin level was significantly lower in deceased individuals (27.2 ± 7.1; p = 0.030). Elevated lactate was associated with mortality, with 60.9% of deceased patients having lactate > 4 mmol/L compared to 21.3% of survivors (p = 0.001), and the mean lactate was significantly higher among deceased individuals (11.0 ± 15.7; p = 0.025). D-dimer was also significantly associated with mortality, with all deceased patients having levels above 1000 ng/ml versus 52.0% of survivors (p = 0.013). Other parameters, including creatinine (p = 0.560), WBC count (p = 0.130), total bilirubin (p = 0.231), direct bilirubin (p = 0.331), blood pH (p = 0.165), liver enzymes (p > 0.05), CRP (p = 0.721), and procalcitonin (p = 0.819), did not show significant associations with mortality. Interventional type and supportive measures Table 3 presents the relationship between intervention types, supportive measures, and 28-day mortality outcomes. Most participants underwent one intervention (93.7%), with the type of intervention not significantly affecting mortality rates including endoscopy (4.0%, p = 1.0), image guided endovascular embolization (IR) (43.7%, p = 0.233), surgery (14.9%, p = 0.172), and conservative management (41.4%, p = 0.622). Despite the lack of statistical, the necessity for supportive measures such as red blood cell (RBC) transfusions, fresh frozen plasma (FFPs), and platelets showcased a trend towards higher mortality. Specifically, patients receiving RBC transfusions (74.7% of the cohort) and those given ≥ 4 units of packed RBCs exhibited a non-significantly higher mortality (p = 0.065 and p = 0.053 respectively). The administration of FFPs and platelets was significantly associated with mortality; 59.4% of deceased individuals received FFPs compared to 32.6% of survivors (p = 0.005), and 34.4% of deceased individuals received platelet transfusions versus 16.9% of survivors (p = 0.026). The use of vasopressors marked the most significant predictor of mortality within the study, with 65.6% of those who died having received vasopressors compared to 18.3% of survivors (p < 0.001). Table 3 Intervention type and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography. Variable Total individuals N (%) Alive 28 days after CT angiography Deceased within 28 days after CT angiography P value Total Number of interventions 0 2(1.1) 1 (0.7) 1 (3.1) 0.476 1 163(93.7) 133 (93.7) 30 (93.8) 2 9(5.2) 8 (5.6) 1 (3.1) Intervention type endoscopy 7(4.0) 6 (4.2) 1 (3.1) 1.00 IR 76(43.7) 59 (41.5) 17 (53.1) 0.233 surgery 26(14.9) 24 (16.9) 2 (6.3) 0.172 Conservative 72(41.4) 60 (42.3) 12 (37.5) 0.622 RBC (%) No 44(25.3) 40 (28.2) 4 (12.5) 0.065 Yes 130(74.7) 102 (71.8) 28 (87.5) Number of PRBC given (%) 0 44(25.3) 40 (28.2) 4 (12.5) 0.053 1–3 85(48.9) 70 (49.3) 15 (46.9) ≥ 4 45(25.9) 32 (22.5) 13 (40.6) FFPs (%) No 108(62.4) 95 (67.4) 13 (40.6) 0.005* Yes 65(37.6) 46 (32.6) 19 (59.4) Platelets (%) No 139 (79.9) 118 (83.1) 21 (65.6) 0.026* Yes 35 (20.1) 24 (16.9) 11 (34.4) Vasopressors No 127 (73.0) 116 (81.7) 11 (34.4) < 0.0001* Yes 47 (27.0) 26 (18.3) 21 (65.6) * Indicates significant p-value. Bleeding characteristics on CTA Table 4 presents the association between bleeding characteristics and mortality. For bleeding etiology, trauma showed a marginally significant association with lower mortality rates (9.4% of death vs. 22.4% of survival, p = 0.050). Abdominal bleeds were associated with increased mortality with 75% of deceased individuals having abdominal bleed (p = 0.022). Specifically retroperitoneal bleeding showed a significant association with higher mortality (15.6% of deaths, p = 0.020). Table 4 association between bleeding characteristics and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography. Variable Total individuals Alive 28 days after CT angiography Deceased within 28 days after CT angiography P value Total (%) Bleeding etiology Trauma 39 (22.4) 36 (25.4) 3 (9.4) 0.050* Tumor 12 (6.9) 10 (7.0) 2 (6.3) 1.0 Idiopathic 60 (34.5) 47 (33.1) 13 (40.6) 0.418 Iatrogenic 29 (16.7) 25 (17.6) 4 (12.5) 0.484 Anti-coagulation 13 (7.5) 9 (6.3) 4 (12.5) 0.262 Coagulopathy 1 (0.6) 1 (0.7) 0 (0.0) 1.0 Bleeding location Neck 10 (5.7) 10 (7.0) 0(0.0) 0.211 Chest 23 (13.2) 16 (11.3) 7 (21.9) 0.145 Abdomen 99 (56.9) 75 (52.8) 24 (75.0) 0.022* Pelvis 26 (14.9) 25 (17.6) 1 (3.1) 0.051 Extremity 27 (15.5) 24 (16.9) 3 (9.4) 0.419 Bleeding category GI 28(16.1) 22 (15.5) 6(18.8) 0.651 Visceral 46 (26.4) 38 (26.8) 8 (25.0) 1.000 Wall 48 (27.6) 41 (28.9) 7 (21.9) 0.424 Retroperitoneal 10 (5.7) 5 (3.5) 5 (15.6) 0.020* Extremity 28 (16.1) 23 (16.2) 5 (15.6) 1.00 Thoracic 10 (5.7) 8 (5.6) 2 (6.3) 1.00 Pulmonary 3 (1.7) 2 (1.4) 1 (3.1) 0.459 Neck 9 (5.2) 9 (6.3) 0 (0.0) 0.214 Presence of hematoma No 16 (9.2) 14 (9.9) 2 (6.3) 0.740 Yes 158 (90.8) 128 (90.1) 30 (93.8) Hematoma size Small 69 (43.7) 61 (47.7) 8 (26.7) 0.037* Large 89 (56.3) 67 (52.3) 22 (73.3) Extravasation No 73 (42) 62 (43.7) 11 (34.4) 0.336 Yes 101 (58) 80 (56.3) 21 (65.6) Extravasation free 86 (85.1) 66 (82.5) 20 (95.2) 0.185 contained 15 (14.9) 14 (17.5) 1 (4.8) Free extravasation volume mild 58 (67.4) 51 (77.3) 7 (35.0) < 0.0001* Substantial 28 (32.6) 15 (22.7) 13 (65.0) Number of bleeding foci 0 51 (37.5) 43 (39.4) 8 (30.0) 0.374 1 53 (39.0) 43 (39.4) 10 (37.0) ≥2 32 (23.5) 17 (21.2) 5 (33.3) * Indicates significant p-value. The presence of hematoma on CT was not associated with increased mortality (p = 0.740). However, the size of hematoma was linked to mortality with large hematomas associated with a higher mortality rate (73.3% of deceased had large hematomas, p = 0.037). Contrast extravasation was more common in deceased individuals (65.6%), but this did not reach statistical significance (p = 0.336). The volume of free extravasation was significantly associated with outcomes; substantial free extravasation was present in 65% of deceased cases (p < 0.001). The number of bleeding foci did not show a significant correlation with mortality (p = 0.374). Impact of CT findings on Patient Survival Kaplan-Meier curves were used to visualize the probability of survival over 28-day period for different clinical variables and used Log Rank (Mantel-Cox) Test Statistics for comparative analysis (supplemental material Table 3 ). Kaplan-Meier estimates, depicted in Fig. 3 A, revealed a divergence in survival probabilities between patients with small and large hematomas. The survival curve for patients with small hematomas consistently demonstrated superior survival over the 28-day period. This visual distinction was statistically significant (p = 0.037). The presence of extravasation did not show a significant difference in survival outcomes with Kaplan-Meier survival curves (Fig. 3 B) following a similar trajectory (p = 0.320). Further analysis of extravasation characteristics revealed no significant difference in survival between free versus contained extravasation (Fig. 3 C) (p = 0.162). However, when examining the impact of the volume of free extravasation on survival, Fig. 3 D showed a notable separation between the curves. Patients with minimal free extravasation had a higher probability of survival compared to those with substantial extravasation (p < 0.001). Multivariate COX analysis The Cox multivariate regression analysis was used to determine which significant variables are independently associated with an increased risk of mortality (Table 5 , Fig. 4 ). The presence of a substantial contrast extravasation was associated with an increased risk with a hazard ratio of 2.49 (95% CI: 1.17–5.29, p = 0.018). Similarly, anticoagulation therapy was associated with a higher risk, with a hazard ratio of 2.46 (95% CI: 1.18–5.11, p = 0.016). Elevated mean INR was also associated with a higher risk, with a hazard ratio of 3.73 (95% CI: 1.78–7.82, p < 0.001). Lastly, the use of vasopressors was associated with the highest risk increase, with a hazard ratio of 4.91 (95% CI: 2.31–10.41, p < 0.001). Table 5 Cox Regression Analysis Factor Hazard Ratio (Exp(B)) 95% Confidence Interval for Exp(B) P-value Substantial extravasation 2.49 1.17–5.29 0.018* Anticoagulation 2.46 1.18–5.11 0.016* Mean INR 3.73 1.78–7.82 < 0.001* Use of Vasopressor 4.91 2.31–10.41 < 0.001* *Indicates significant p-value. Inter-rater Reliability Analysis for Hematoma Size and active bleeding Assessment Inter-rater Reliability Analysis is presented in supplemental material Table 4 . The inter-rater reliability for hematoma size was found to be substantial (kappa value of 0.668, 95% CI between 0.578 to 0.758, p < 0.0001). For the assessment of extravasation, the inter-rater reliability for the presence of extravasation was found to be almost perfect (kappa value of 0.867, 95% between 0.781 to 0.953, p < 0.0001) and almost perfect for free versus contained extravasation (kappa value of 0.838, 95% CI between 0.722 to 0.955 p < 0.0001). For free extravasation volume the inter-rater reliability was substantial (kappa value of 0.694, 95% CI between 0.568 to 0.821, p < 0.0001). Discussion In the evaluation of 28-day mortality predictors among patients undergoing CT angiography for suspected active bleeding, significant associations were identified with various factors. The study found that increased age, higher BMI, the presence of comorbidities in particular malignancy, and the use of anticoagulants, antiplatelets and/or thrombolytics were associated with higher mortality. Laboratory and hemodynamic parameters, including presence of hypotension, hypoxia, decreased hemoglobin, decreased platelet counts, high blood urea nitrogen, elevated INR, elevated lactate levels, decreased albumin, and elevated D-dimer levels, were also associated with increased mortality. Imagine findings, particularly the size of the hematoma, the extravasation volume, abdominal location specifically retroperitoneal bleeds were significantly associated with increased mortality. The need for platelets and FFPs transfusions and vasopressor use were also significantly associated with increased mortality. The Cox multivariate analysis showed that substantial active bleed, anticoagulation therapy, elevated mean INR and the use of vasopressors were independent predictors of mortality within 28 days. The study also shows that the type of intervention (including endoscopy, interventional radiology, surgery, or conservative management) did not significantly impact mortality rates. CTA Bleeding characteristics Substantial contrast extravasation was the only imaging finding independently associated with mortality. The Cox model showed that patients with substantial contrast extravasation had over a 2-fold increase in the risk of dying within 28 days. This indicates that the severity of bleeding plays a more critical role in determining patient outcomes than merely the presence of bleeding or the size of a hematoma. Our results are compatible with existing literature. Borror et al. showed increased mortality and transfusion requirements with patient with high rate of active bleed > 20 cc/min [ 13 ]. Chomchalerm et al. showed that rapid active contrast extravasation (defined as > 450% increase in perimeter of extravasation between arterial and portovenous phases) was significantly associated with increased 24h mortality percentage (16.7%, p 8 mm was the only imaging marker independently predictive of in-hospital mortality (p = 0.043) [ 15 ]. On the other hand, Khdhir et al. suggested that small bleeds, especially ones seen on delayed phases caries no diagnostic and possibly no clinical relevance [ 16 ]. The significance of extravasation volume likely stems from its capacity to represent the intensity of the bleeding episode, denoting present or impending hemodynamic instability. Still, the lack of independent predictive value for certain markers like hematoma size does not necessarily diminish their role in the evaluation of patients with suspected bleed, as these indicators still contribute critical information for initial diagnosis and management planning. Moreover, although the reader agreeability was high, a precise quantification of extravasation volume is important to improve the accuracy of prognosis prediction. Coagulation profile and laboratory findings Antithrombotic therapies and mean INR were independently associated with over a 2-fold and 3- fold increase in mortality respectively. This is expected since these parameters serve as indicators of coagulopathy, which can exacerbate bleeding events [ 6 , 8 , 10 ]. The results are in accordance with existing literature, most recently, Kaewlai et al. who found that increased PTT was independently associated with mortality in patients undergoing abdominopelvic CT (p = 0.005) [ 15 ]. The original analysis showed an association between hypotension, hemoglobin level at presentation, and elevated lactate levels with 28-day mortality. Elevated lactate levels, indicates systemic hypoperfusion and end-organ ischemia leading to poor outcomes in acute bleeding and trauma patient[ 17 – 19 ] even when adjusting for blood pressure [ 19 ]. Holstein et al. showed that non-survivors in patients with pelvic fractures had lower initial blood hemoglobin concentration (6.7 ± 2.9 versus 9.8 ± 3.0 g/dL) and systolic arterial blood pressure (77 ± 27 versus 106 ± 24 mmHg) [ 20 ]. Marmo et al. showed independent association between hemoglobin level and mortality in patients with GI bleed [ 21 ]. Yoo Jin Lee et al found that hypotension during hospitalization in patients with GI bleed was associated with 30-day mortality in contrast to hemoglobin level which was not associated with mortality [ 22 ]. Type of intervention The type of intervention (endoscopy, endovascular embolization, surgery, or conservative management) did not significantly affect mortality rates, suggesting that outcomes may be more influenced by the patient's clinical condition and the necessity for supportive care rather than the specific clinical management strategy. In the literature, a retrospective comparison of IR with surgery in patients with non-variceal upper gastrointestinal hemorrhage (NVUGIH) demonstrated equivalent mortality and clinical success despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities [ 23 ]. A meta-analysis by Tarasconi et al. found that, compared to surgery, TAE exhibits a higher rebleeding rate, but similar mortality rates in patients with NVUGIH [ 24 ]. With regards to trauma setting, Forberg et al. found a significant increased risk of 30-day mortality ( P = 0.04) in patients with active bleeding treated with explorative laparotomy and surgical packing compared to angiography and embolization [ 25 ]. Aoki et al. found no significant difference in hospital survival between embolization and laparotomy in patients with solid organ injury who responded to initial resuscitation [ 26 ]. On the other hand, the necessity for supportive measures, in particular fresh frozen plasma, platelets, and vasopressors were indicative of a trend towards higher mortality. The need for vasopressors was independently associated with the highest risk increase with around 5-fold increased risk of mortality. This suggests that while the choice of intervention might not directly influence mortality, the severity of bleeding, as necessitated by the need for extensive hemodynamic support, can affect patient’s outcomes. This reiterates the need for rapid intervention to mitigate the progression into hemodynamic instability, in accordance with suggested guidelines [ 6 ]. This also necessitates preemptive measures to prevent the onset of hemodynamic instability. Additionally, procedural factors such as interventionist experience and number of bleeding foci may affect procedural time and should be considered when optimizing treatment planning [ 27 ]. Limitations The retrospective design, single-center setting, and sample size may limit the generalizability of the findings. Additionally, the lack of focus on specific body regions makes the study broadly inclusive which may reduce its region-specific applicability. Future research should focus on prospective studies to validate these findings. Conclusion The findings indicate that sever hemodynamic instability, coagulation abnormalities, and contrast extravasation severity are critical determinants of 28-day mortality in patients with suspected active bleeding undergoing CTA. Notably the choice of intervention did not directly influence mortality rates, suggesting that outcomes may be more influenced by the patient's clinical condition and the necessity for supportive care rather than the specific clinical management strategy. This highlights the importance of early and accurate assessment of bleeding severity and underscores the need for rapid bleeding management and the implementation of preventive measures against hemodynamic instability. Future efforts should focus on creating standardized protocols that incorporate key predictors into the decision-making process for the management of bleeding patients. Declarations Authors disclosure None. Funding source: None. References Wortman JR, Landman W, Fulwadhva UP, Viscomi SG, Sodickson AD (2017) CT angiography for acute gastrointestinal bleeding: What the radiologist needs to know. Br J Radiol 90:1–9 Copland A, Munroe CA, Friedland S, Triadafilopoulos G (2010) Integrating urgent multidetector CT scanning in the diagnostic algorithm of active lower GI bleeding. Gastrointest Endosc 72:402–405 Soto JA, Anderson SW (2012) Multidetector CT of blunt abdominal trauma. Radiology 265:678–693 Gould JE, Vedantham S (2006) The role of interventional radiology in trauma. Semin Intervent Radiol 23:270–278 Touma L, Cohen S, Cassinotto C, Reinhold C, Barkun A, Tran VT et al (2019) Transcatheter Arterial Embolization of Spontaneous Soft Tissue Hematomas: A Systematic Review. Cardiovasc Intervent Radiol 42:335–343 Rossaint R, Afshari A, Bouillon B, Cerny V, Cimpoesu D, Curry N et al (2023) The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care 27:1–45 Maegele M (2019) The diagnosis and treatment of acute traumatic bleeding and coagulopathy. Dtsch Arztebl Int 116:799–806 Carvalho M, Rodrigues A, Gomes M, Carrilho A, Nunes AR, Orfão R et al (2016) Interventional algorithms for the control of coagulopathic bleeding in surgical, trauma, and postpartum settings: Recommendations from the Share Network Group. Clin Appl Thromb Hemost 22:121–137 Kokabi N, Shuaib W, Xing M, Harmouche E, Wilson K, Johnson JO et al (2014) Intra-abdominal solid organ injuries: An enhanced management algorithm. Can Assoc Radiol J 65:301–309 Tomaselli GF, Mahaffey KW, Cuker A, Dobesh PP, Doherty JU, Eikelboom JW et al (2020) 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 76:594–622 Oakland K, Chadwick G, East JE, Guy R, Humphries A, Jairath V et al (2019) Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 68:776–789 Ely JW, Kennedy CM, Clark EC, Bowdler NC (2006) Abnormal uterine bleeding: A management algorithm. J Am Board Fam Med 19:590–602 Borror W, Gaski GE, Steenburg S (2019) Abdominopelvic bleed rate on admission CT correlates with mortality and transfusion needs in the setting of blunt pelvic fractures: a single institution pilot study. Emerg Radiol 26:37–44 Chomchalerm G, Kaewlai R, Tongsai S, Chatpuwaphat J, Thamtorawat S, Praditsuktavorn B et al (2025) Rapid, moderate, or slow bleeding? CT analysis of abdominopelvic active vascular contrast extravasation classes and mortality outcomes. Eur Radiol Kaewlai R, Chomchalerm G, Tongsai S, Chatpuwaphat J, Chatkaewpaisal A, Khamman P et al (2024) Predictors and pathways of in-hospital mortality in active vascular contrast extravasation detected on abdominopelvic CT. Insights Imaging. ;15 Khdhir M, Ghosn Y, Jabbour Y, Abbas N, Tarcha Z, Kayali M et al (2024) Does delayed phase imaging in CT angiography provide additional information in patients with suspected active bleeding? Emerg Radiol 31:439–446 Gulen M, Satar S, Tas A, Avci A, Nazik H (2019) Toptas Firat B. Lactate Level Predicts Mortality in Patients with Upper Gastrointestinal Bleeding. Gastroenterol Res Pract. ;2019 Lee SH, Min YW, Bae J, Lee H, Min BH, Lee JH et al (2017) Lactate parameters predict clinical outcomes in patients with nonvariceal upper gastrointestinal bleeding. J Korean Med Sci 32:1820–1827 Odom SR, Howell MD, Silva GS, Nielsen VM, Gupta A, Shapiro NI et al (2013) Lactate clearance as a predictor of mortality in trauma patients. J Trauma Acute Care Surg 74:999–1004 Holstein JH, Culemann U, Pohlemann T (2012) What are predictors of mortality in patients with pelvic fractures? Trauma. Clin Orthop Relat Res 470:2090–2097 Marmo R, Koch M, Cipolletta L, Capurso L, Pera A, Bianco MA et al (2008) Predictive factors of mortality from nonvariceal upper gastrointestinal hemorrhage: A multicenter study. Am J Gastroenterol 103:1639–1647 Sadiku E, Hoti K, Bruci A, Tac S, Bruci A, Kraja B (2023) Predictive Factors of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding. Int J Biomed 13:110–116 Mirsadraee S, Tirukonda P, Nicholson A, Everett SM, McPherson SJ (2011) Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review. Clin Radiol 66:500–509 Tarasconi A, Baiocchi GL, Pattonieri V, Perrone G, Abongwa HK, Molfino S et al (2019) Transcatheter arterial embolization versus surgery for refractory non-variceal upper gastrointestinal bleeding: A meta-analysis. World J Emerg Surg 14:1–13 Froberg L, Helgstrand F, Clausen C, Steinmetz J, Eckardt H (2016) Mortality in trauma patients with active arterial bleeding managed by embolization or surgical packing: An observational cohort study of 66 patients. J Emerg Trauma Shock 9:107–114 Aoki M, Abe T, Hagiwara S, Saitoh D, Oshima K (2021) Embolization versus Surgery for Stabilized Patients with Solid Organ Injury. J Vasc Interv Radiol 32:1150–1155e5 Ghosn Y, Khdhir M, Jabbour Y, Dushfunian D, Kobeissi I, Abbas N et al (2024) Factors affecting radiation dose, radiation exposure time and procedural time in arterial embolization for active hemorrhage. Emerg Radiol Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7390228","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":501397110,"identity":"7a206a63-ba36-4627-aefc-2d7dc5771af8","order_by":0,"name":"Mihran Khdhir","email":"","orcid":"","institution":"Yale School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Mihran","middleName":"","lastName":"Khdhir","suffix":""},{"id":501397111,"identity":"9bc34355-81ad-4e44-998b-595662677bd6","order_by":1,"name":"Youssef Ghosn","email":"","orcid":"https://orcid.org/0000-0002-2032-346X","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Youssef","middleName":"","lastName":"Ghosn","suffix":""},{"id":501397112,"identity":"2ca91334-d0c4-4b34-9121-2b7b54ca55ae","order_by":2,"name":"Yara Jabbour","email":"","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Yara","middleName":"","lastName":"Jabbour","suffix":""},{"id":501397113,"identity":"3dba585e-7800-4bd2-b2ad-40aaa1717121","order_by":3,"name":"David Dushfunian","email":"","orcid":"","institution":"Northwestern University","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Dushfunian","suffix":""},{"id":501397114,"identity":"f77a5710-4622-4444-b26d-fa55499cd2e0","order_by":4,"name":"Mohamad Kayali","email":"","orcid":"","institution":"University of Iowa Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Mohamad","middleName":"","lastName":"Kayali","suffix":""},{"id":501397115,"identity":"32856120-f4b5-4ceb-a7a0-eae72dab9d4b","order_by":5,"name":"Ziad Tarcha","email":"","orcid":"","institution":"Saint Louis Children’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ziad","middleName":"","lastName":"Tarcha","suffix":""},{"id":501397116,"identity":"58f0643f-cf0b-4adf-975f-f6a08bcfeac7","order_by":6,"name":"Reve Chahine","email":"","orcid":"","institution":"University of Michigan Health System","correspondingAuthor":false,"prefix":"","firstName":"Reve","middleName":"","lastName":"Chahine","suffix":""},{"id":501397117,"identity":"628d79f2-3a74-4efc-a9ce-ce38367bfb36","order_by":7,"name":"Walaa El Sheikh","email":"","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Walaa","middleName":"El","lastName":"Sheikh","suffix":""},{"id":501397118,"identity":"5eaaa81f-ce17-4f72-9e7f-2128841b9799","order_by":8,"name":"Mustafa Natout","email":"","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Mustafa","middleName":"","lastName":"Natout","suffix":""},{"id":501397119,"identity":"8d726a8c-a44e-488a-a29a-5ae835e5e3df","order_by":9,"name":"Riad Khouzami","email":"","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Riad","middleName":"","lastName":"Khouzami","suffix":""},{"id":501397120,"identity":"16e0b96f-b3cb-4b98-94d4-b39f7f99dcc2","order_by":10,"name":"Hani Tamim","email":"","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Hani","middleName":"","lastName":"Tamim","suffix":""},{"id":501397121,"identity":"50fadc17-3c4b-4eb8-93e0-293d0274574a","order_by":11,"name":"Nadim Muallem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAr0lEQVRIiWNgGAWjYFAC/scPPjAwJABZBgwMBQeI0cLDZjgDrsWAOC0M0jwkaTEXO3vA2KbmcB4De/M2CQaDO4S1WM7OS3icc+xwMQPPsTKglmeEtRjcTjAwzmE7nNggkWMG1HKYOC3SFv+AWuTfEK0lx0CasQ1kCw/RWtLSDHv70ovZeNKKLRKI80vy4Qc/vlnn8bMf3njjQwURIQYHbCAigQQNo2AUjIJRMArwAABXVTlvrEgYnQAAAABJRU5ErkJggg==","orcid":"","institution":"American University of Beirut Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Nadim","middleName":"","lastName":"Muallem","suffix":""}],"badges":[],"createdAt":"2025-08-17 03:38:28","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7390228/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7390228/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89454936,"identity":"66aed6d6-5cba-42c3-80c8-633b22e6f328","added_by":"auto","created_at":"2025-08-20 06:47:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":614495,"visible":true,"origin":"","legend":"\u003cp\u003eCT angiography of a patient presenting with intermittent hematochezia. (A) Non-Enhanced CT showing no detectable hematoma. (B) Arterial phase CT showing faint contrast extravasation in the ascending colon (yellow arrow). Finding was considered as a free mild extravasation by all readers.\u003c/p\u003e","description":"","filename":"FIgure1CT1Labeled.png","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/47c507c575bcfabd4d4d605a.png"},{"id":89455990,"identity":"9ce961a2-3097-4750-bfbf-c54767eb593a","added_by":"auto","created_at":"2025-08-20 06:55:59","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":573344,"visible":true,"origin":"","legend":"\u003cp\u003eCT angiography of a patient with pancreatic cancer presenting with hematochezia, hematemesis and hemodynamic instability. Axial (A) and coronal (B) Arterial phase CT angiograph demonstrating mass eroding into the 3\u003csup\u003erd\u003c/sup\u003e segment of the duodenum as well as the superior mesenteric artery (SMA) (green arrow). Extravagated contrast from SMA is seen reaching the proximal jejunum. Finding was considered as a free substantial extravasation by all readers.\u003c/p\u003e","description":"","filename":"Figure2CT02Labeled.png","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/f81ffa3b2049f87fb56b5139.png"},{"id":89454939,"identity":"55cb6d96-57fb-4261-8f89-927207f787fc","added_by":"auto","created_at":"2025-08-20 06:47:59","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":118753,"visible":true,"origin":"","legend":"\u003cp\u003ePanel A-D: Kaplan-Meier survival curves for a 28-day period post-treatment in patients with suspected active bleeding, categorized by different clinical parameters. Panel A illustrates survival based on hematoma size. Panel B compares survival in patients with and without extravasation. Panel C shows survival based on whether extravasation is free or contained. Panel D differentiates survival probability between patients with minimal and substantial free extravasation. Crosses represent censored data, indicating patients lost to follow-up or surviving beyond the study period.\u003c/p\u003e","description":"","filename":"image.png","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/7b49815c1dc825917970147a.png"},{"id":89456346,"identity":"72cfa429-e73f-4ed3-b71f-d274dfcf876d","added_by":"auto","created_at":"2025-08-20 07:04:00","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":16331,"visible":true,"origin":"","legend":"\u003cp\u003eForest Plot illustrating the hazard ratios (HR) and 95% confidence intervals for risk factors associated with 28-day mortality in patients with suspected active bleeding, as determined by Cox Proportional Hazards Model analysis. Points to the right of the blue dashed line (HR \u0026gt; 1) indicate increased risk, while points to the left (HR \u0026lt; 1) indicate decreased risk.\u003c/p\u003e","description":"","filename":"image.png","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/e191fd1ace3164b4ca2b39a6.png"},{"id":89457342,"identity":"a72a9aaa-8c3f-4569-b0be-b52a22d0ee52","added_by":"auto","created_at":"2025-08-20 07:12:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3121929,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/642249b3-3513-4c5a-9add-91017a4f9ba1.pdf"},{"id":89454935,"identity":"d6b0e826-74c7-42be-8323-b8a5ff51c427","added_by":"auto","created_at":"2025-08-20 06:47:59","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":29022,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementalmaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-7390228/v1/b9d2eaf7ee780c801537a9bc.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePrognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding\u003c/p\u003e","fulltext":[{"header":"Highlights","content":"\u003cp\u003e1- Substantial contrast extravasation on CTA was independently associated with 28-day mortality in patients with suspected active bleeding.\u003c/p\u003e\u003cp\u003e2- Anticoagulation, elevated INR, and vasopressor use were also independently associated with increased mortality.\u003c/p\u003e\u003cp\u003e3- The type of intervention was not associated with mortality.\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003eThe critical role of Computed Tomography Angiography (CTA) and Interventional Radiology (IR) in diagnosing and managing active bleeding cannot be overstated. CTA ability to identify a bleed, delineate its extent, and detect active extravasation sites help guiding the selection of appropriate interventional strategies [\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, the prognosis of patients with suspected active bleeding remains an interplay of various factors with multiple proposed management strategies that generally depend on the suspected etiology, hemodynamic stability, and coagulation profile [\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10 CR11\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe integration of CTA findings, such as hematoma size and presence of active contrast extravasation, alongside the clinical data and types of interventions received, could provide valuable insights into the prognosis of patients presenting with suspected active bleed. This study aims to evaluate the predictors of 28-day mortality in such patients, focusing on demographic variables, laboratory data, imaging findings, and the type of intervention performed. The aim is to critically evaluate the role of imaging and interventions while providing a comprehensive analysis that could inform future clinical practices and guidelines.\u003c/p\u003e"},{"header":"Materials and Methods sections","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design and Population\u003c/h2\u003e\u003cp\u003e This was a retrospective study approved by the institutional review board (IRB), which waived the requirement for informed consent. The picture archiving and communication system (PACS) was accessed to identify patients who underwent multi-phasic CT angiography (CTA) of the neck, chest, abdomen and/or pelvis, and extremities for suspected active bleed between January 2019 and November 2021. PACS was searched for cases with words \u0026ldquo;bleed\u0026rdquo;, \u0026ldquo;hemorrhage\u0026rdquo; and/or \u0026ldquo;hematoma\u0026rdquo; within the clinical indication section of CTA reports. Search was limited to the emergency department and inpatient cases. Patients were excluded if the CT protocol did not include non-enhanced, arterial, and proto-venous phases. Clinical and laboratory data were extracted from electronic medical records, including age, sex, body mass index (BMI), comorbidities, medication use, laboratory findings when active bleed was suspected, and the suspected bleeding etiology. Information on the type of interventions received, and mortality outcomes within 28 days of the CTA were also collected.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eCTA protocol\u003c/h3\u003e\n\u003cp\u003eCTA was performed on one of three CT scanners: 256 slice, IQon Spectral CT, Philips Healthcare; 256 slice, Brilliance iCT, Philips Healthcare; or 128 slice, Incisive, Philips Healthcare. Following acquisition of a non-contrast CT, low-osmolar iodinated contrast (350 mg/ml Iodine) was administered by power injector intravenously at 4 ml/ sec. Arterial-phase imaging was triggered using bolus tracking. The portal/venous phase was acquired 80s to 100s. All CT scans were reconstructed and archived with contiguous thin sections of 1 mm thickness and routine acquisition and archiving of coronal and sagittal reconstructions.\u003c/p\u003e\n\u003ch3\u003eCTA images interpretation\u003c/h3\u003e\n\u003cp\u003eCTA images were reviewed by an interventional radiologist, a body imaging radiologist, and a general radiologist independently (with 10 years, 7 years, and 20 years of experience respectively). The readers had no access to other images or clinical information. CT images were initially reviewed to identify the region of interest (neck, chest, abdomen, pelvis, extremities). Each radiologist independently reviewed CTA images and assessed the images to diagnose whether there was a hematoma, the hematoma size (small vs large), the presence of contrast extravasation, whether the extravasation is contained (pseudoaneurysm) or free, and the extravasation volume [mild (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) vs substantial (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)]. No quantitative measurement of the extravasation volume or hematoma size was performed. As all imaging variables were binary, consensus was determined by a unanimous (3 votes) or majority (2 votes) agreement among the readers for each finding.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eAssociations between various factors and mortality within 28 days were analyzed using chi-square tests for categorical variables and independent t-tests for continuous variables. Inter-rater reliability analysis was performed involving three raters to assess the presence of hematoma on CTA, hematoma size, presence of contrast extravasation, and degree of extravasation, employing Fleiss' kappa to measure agreement beyond chance. Kaplan-Meier curves were used to visualize the probability of survival for different imaging variables and used Log Rank (Mantel-Cox) Test Statistics for comparative analysis. Stepwise Multivariate Cox regression analysis of the significant variables was performed to identify independent predictors of mortality. Statistical analysis was performed using SPSS version 17.0. A p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eDemographic and comorbidities\u003c/h2\u003e\u003cp\u003eA total of 174 cases were analyzed, with an 82% survival rate (n\u0026thinsp;=\u0026thinsp;142) and an 18% mortality rate (n\u0026thinsp;=\u0026thinsp;32) within the 28-day period following CT angiography (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between age, sex, comorbidities, and medication with death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal individuals\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAlive 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeceased within 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e174 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean Age (\u0026plusmn;\u0026thinsp;SD) (yrs)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57.2\u0026thinsp;\u0026plusmn;\u0026thinsp;22.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e54.9\u0026thinsp;\u0026plusmn;\u0026thinsp;22.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67.7\u0026thinsp;\u0026plusmn;\u0026thinsp;19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.002*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge group, N (%) (yrs)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;18\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11(6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9(6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003e0.005*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u0026ndash;45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41(28.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e46\u0026ndash;65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34 (23.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 (25.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;66\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79 (45.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58 (40.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21 (65.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean BMI (+- SD) (kg/m2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.3\u0026thinsp;\u0026plusmn;\u0026thinsp;8.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.144\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI group (kg/m2), N(%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;18.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9 (7.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e0.023*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18.5\u0026ndash;29.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e108 (69.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e94 (73.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14 (50.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37 (23.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (19.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12 (42.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex, N (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e115 (66.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e98 (69.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17 (53.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.086\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (33.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (31.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15 (46.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAny comorbidity, N (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53 (30.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.015*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e121 (69.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e93 (65.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28 (87.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComorbidities, Mean (+- SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.092\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalignancy, N (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e117 (67.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e101 (71.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16 (50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.021*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57 (32.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41 (28.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16 (50.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMedications\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnticoagulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e120(69.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e107 (75.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13 (40.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54 (31.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35 (24.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19 (59.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAntiplatelet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e146 (83.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e123 (86.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23 (71.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.040*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (16.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (28.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThrombolytic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e172 (98.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (100.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30 (93.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.033*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (1.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNSAID\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e163 (93.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e134 (94.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29 (90.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.427\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (9.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChemotherapy drug/s\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e142 (81.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e119 (83.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23 (71.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.116\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (18.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23 (16.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (28.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003eIndicates significant p-value.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eRegarding age distribution, 6.3% (n\u0026thinsp;=\u0026thinsp;11) of the participants were 18 years or younger, 24.1% (n\u0026thinsp;=\u0026thinsp;42) were between 19 and 45 years, 24.1% (n\u0026thinsp;=\u0026thinsp;42) were between 46 and 65 years, and 45.4% (n\u0026thinsp;=\u0026thinsp;79) were 66 years or older. A statistically significant higher percentage of deceased patients (65.6%) fell into the oldest age group (\u0026ge;\u0026thinsp;66 years) compared to survivors (40.8%) (p\u0026thinsp;=\u0026thinsp;0.005). Sex distribution showed 66.1% male and 33.9% female participants, with no significant deference in mortality (69.0% males vs. 53.1% females, p\u0026thinsp;=\u0026thinsp;0.086).\u003c/p\u003e\u003cp\u003eThe mean BMI was 26.26 kg/m\u003csup\u003e2\u003c/sup\u003e (SD\u0026thinsp;=\u0026thinsp;6.42), with no significant difference between survivors and deceased individuals (p\u0026thinsp;=\u0026thinsp;0.144). However, there was a significant difference in mortality with the \u0026ge;\u0026thinsp;30 kg/m\u003csup\u003e2\u003c/sup\u003e BMI groups showing the highest rate of death (19.5% alive vs. 42.9% deceased, p\u0026thinsp;=\u0026thinsp;0.023).\u003c/p\u003e\u003cp\u003eThe presence of any comorbidity was associated with increased mortality (87.5% in deceased vs. 65.5% in survivors, p\u0026thinsp;=\u0026thinsp;0.015). The number of comorbidities showed a trend towards higher mortality, but this was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.092).\u003c/p\u003e\u003cp\u003eNo significant association was observed between mortality and hypertension, diabetes, heart disease, CKD, dialysis, peripheral arterial disease, cerebrovascular disease, chronic lung disease, cirrhosis, or COVID-19 status (supplemental material Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). However, individuals with malignancy had a significantly higher mortality rate (50.0% of decreased vs. 28.9% of survivors, p\u0026thinsp;=\u0026thinsp;0.021).\u003c/p\u003e\u003cp\u003eThe use of anticoagulation medications was significantly associated with mortality, with 59.4% of deceased patients having received anticoagulants compared to 24.6% of survivors (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, the use of antiplatelet medications was more common among deceased patients (28.1%) than survivors (13.4%), and this difference was significant (p\u0026thinsp;=\u0026thinsp;0.040). Additionally, thrombolytic therapy was only used by deceased patients (6.3%) (p\u0026thinsp;=\u0026thinsp;0.033).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eLaboratory findings\u003c/h3\u003e\n\u003cp\u003eThe association between laboratory findings at presentation and death within 28 days of presentation are shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (categorical variables) and supplementary material table 2 (contentious variables).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between abnormal lab findings (categorical) and bleeding location at presentation and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal individuals n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAlive 28 days after CT angiography n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeceased within 28 days after CT angiography n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal N (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemoglobin baseline (g/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43 (28.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37(30.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(21.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.362\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8-11.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e97 (65.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78(64.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(67.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (6.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(5.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3(10.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemoglobin at presentation (g/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23 (13.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(15.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e0.017*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8-11.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67(47.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(34.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73 (42.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53(37.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20(62.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemoglobin drop (g/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (51.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68(56.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(32.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.022*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (48.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53(43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(67.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWBC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;4000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (2.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(2.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.130\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4000\u0026ndash;11000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75 (43.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e66(46.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(28.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;11000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e94 (54.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72(50.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22(68.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(23.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(28.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.560\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;1.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e132 (75.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e109(76.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23(71.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65 (37.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(31.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20(64.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e107 (62.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96(68.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(35.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal Bilirubin (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (11.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(8.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(19.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.231\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81 (89.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64(91.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(81.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect bilirubin (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(4.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(9.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.331\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85 (94.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e66(95.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(90.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;7.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36 (31.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(27.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7.35\u0026ndash;7.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44 (38.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34(38.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(37.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;7.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35 (30.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30(34.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(18.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eINR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;1.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e141 (85.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e122(91.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(61.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;1.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24 (14.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(9.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(38.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLactate (mmol/L)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38 (36.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35(43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3(13.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34 (33.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28(35.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(26.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31 (30.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17(21.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14(60.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eD dimer (ng/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003e0.013*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (35.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(48.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0(0.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (64.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13(52.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(100.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003eIndicates significant p-value.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eHemoglobin level showed significant associations with mortality. At presentation, 62.5% (20 out of 32) of deceased patients had hemoglobin\u0026thinsp;\u0026lt;\u0026thinsp;8 g/dL, compared to 37.3% (53 out of 142) of survivors (p\u0026thinsp;=\u0026thinsp;0.017), and a significant hemoglobin drop (\u0026ge;\u0026thinsp;2 g/dL) was observed in 59.4% of deceased patients versus 37.3% of survivors (p\u0026thinsp;=\u0026thinsp;0.022). The mean hemoglobin level at presentation was lower in deceased individuals (7.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6) compared to survivors (9.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the average drop in hemoglobin was significantly greater in deceased individuals (3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.504) versus survivors (2.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4) (p\u0026thinsp;=\u0026thinsp;0.001). However, baseline hemoglobin\u0026thinsp;\u0026ge;\u0026thinsp;12 g/dL did not show a significant association with mortality, being present in 18.8% (6 out of 32) of deceased patients compared to 26.1% (37 out of 142) of survivors (p\u0026thinsp;=\u0026thinsp;0.362).\u003c/p\u003e\u003cp\u003eHypotension and hypoxia at presentation were also strongly associated with mortality, with 75% of deceased patients presenting with hypotension (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and 28.1% with hypoxia (p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003eCoagulation markers were significantly associated with mortality: elevated INR (\u0026gt;\u0026thinsp;1.5) was present in 38.7% of deceased patients versus 9.0% of survivors (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the mean INR was also higher among the deceased (1.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4; p\u0026thinsp;=\u0026thinsp;0.015); similarly, mean prothrombin time (PT) was higher in deceased patients (24.4\u0026thinsp;\u0026plusmn;\u0026thinsp;18.7; p\u0026thinsp;=\u0026thinsp;0.011). Platelet count demonstrated a marginal association with mortality, with deceased individuals showing lower mean platelet counts (184,262.5\u0026thinsp;\u0026plusmn;\u0026thinsp;122,675.9; p\u0026thinsp;=\u0026thinsp;0.050).\u003c/p\u003e\u003cp\u003eElevated BUN was significantly associated with mortality, observed in 64.5% of deceased patients compared to 35.5% with levels\u0026thinsp;\u0026le;\u0026thinsp;25 mg/dL (p\u0026thinsp;=\u0026thinsp;0.001), and the mean BUN was higher among deceased individuals (40.2\u0026thinsp;\u0026plusmn;\u0026thinsp;35.7) compared to survivors (26.45\u0026thinsp;\u0026plusmn;\u0026thinsp;24.3) (p\u0026thinsp;=\u0026thinsp;0.010). Albumin level was significantly lower in deceased individuals (27.2\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1; p\u0026thinsp;=\u0026thinsp;0.030).\u003c/p\u003e\u003cp\u003eElevated lactate was associated with mortality, with 60.9% of deceased patients having lactate\u0026thinsp;\u0026gt;\u0026thinsp;4 mmol/L compared to 21.3% of survivors (p\u0026thinsp;=\u0026thinsp;0.001), and the mean lactate was significantly higher among deceased individuals (11.0\u0026thinsp;\u0026plusmn;\u0026thinsp;15.7; p\u0026thinsp;=\u0026thinsp;0.025).\u003c/p\u003e\u003cp\u003eD-dimer was also significantly associated with mortality, with all deceased patients having levels above 1000 ng/ml versus 52.0% of survivors (p\u0026thinsp;=\u0026thinsp;0.013).\u003c/p\u003e\u003cp\u003eOther parameters, including creatinine (p\u0026thinsp;=\u0026thinsp;0.560), WBC count (p\u0026thinsp;=\u0026thinsp;0.130), total bilirubin (p\u0026thinsp;=\u0026thinsp;0.231), direct bilirubin (p\u0026thinsp;=\u0026thinsp;0.331), blood pH (p\u0026thinsp;=\u0026thinsp;0.165), liver enzymes (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), CRP (p\u0026thinsp;=\u0026thinsp;0.721), and procalcitonin (p\u0026thinsp;=\u0026thinsp;0.819), did not show significant associations with mortality.\u003c/p\u003e\n\u003ch3\u003eInterventional type and supportive measures\u003c/h3\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the relationship between intervention types, supportive measures, and 28-day mortality outcomes. Most participants underwent one intervention (93.7%), with the type of intervention not significantly affecting mortality rates including endoscopy (4.0%, p\u0026thinsp;=\u0026thinsp;1.0), image guided endovascular embolization (IR) (43.7%, p\u0026thinsp;=\u0026thinsp;0.233), surgery (14.9%, p\u0026thinsp;=\u0026thinsp;0.172), and conservative management (41.4%, p\u0026thinsp;=\u0026thinsp;0.622). Despite the lack of statistical, the necessity for supportive measures such as red blood cell (RBC) transfusions, fresh frozen plasma (FFPs), and platelets showcased a trend towards higher mortality. Specifically, patients receiving RBC transfusions (74.7% of the cohort) and those given\u0026thinsp;\u0026ge;\u0026thinsp;4 units of packed RBCs exhibited a non-significantly higher mortality (p\u0026thinsp;=\u0026thinsp;0.065 and p\u0026thinsp;=\u0026thinsp;0.053 respectively). The administration of FFPs and platelets was significantly associated with mortality; 59.4% of deceased individuals received FFPs compared to 32.6% of survivors (p\u0026thinsp;=\u0026thinsp;0.005), and 34.4% of deceased individuals received platelet transfusions versus 16.9% of survivors (p\u0026thinsp;=\u0026thinsp;0.026). The use of vasopressors marked the most significant predictor of mortality within the study, with 65.6% of those who died having received vasopressors compared to 18.3% of survivors (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eIntervention type and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal individuals\u003c/p\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAlive 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeceased within 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of interventions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2(1.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1 (0.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.476\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e163(93.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e133 (93.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30 (93.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9(5.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8 (5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntervention type\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eendoscopy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7(4.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (4.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76(43.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59 (41.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17 (53.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.233\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003esurgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26(14.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.172\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConservative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e72(41.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60 (42.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12 (37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.622\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRBC (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44(25.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40 (28.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e130(74.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e102 (71.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e28 (87.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of PRBC given (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44(25.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40 (28.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.053\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e85(48.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e70 (49.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15 (46.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45(25.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32 (22.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (40.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFFPs (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e108(62.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e95 (67.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (40.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.005*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65(37.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46 (32.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19 (59.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlatelets (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e139 (79.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e118 (83.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21 (65.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.026*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35 (20.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11 (34.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVasopressors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e127 (73.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e116 (81.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11 (34.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47 (27.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26 (18.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21 (65.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003eIndicates significant p-value.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eBleeding characteristics on CTA\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the association between bleeding characteristics and mortality. For bleeding etiology, trauma showed a marginally significant association with lower mortality rates (9.4% of death vs. 22.4% of survival, p\u0026thinsp;=\u0026thinsp;0.050). Abdominal bleeds were associated with increased mortality with 75% of deceased individuals having abdominal bleed (p\u0026thinsp;=\u0026thinsp;0.022). Specifically retroperitoneal bleeding showed a significant association with higher mortality (15.6% of deaths, p\u0026thinsp;=\u0026thinsp;0.020).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eassociation between bleeding characteristics and death within 28 days of presentation in individuals with suspected active bleed who underwent CT angiography.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal individuals\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAlive 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeceased within 28 days after CT angiography\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBleeding etiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTrauma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (22.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36 (25.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (9.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.050*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (6.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10 (7.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIdiopathic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47 (33.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (40.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.418\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIatrogenic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25 (17.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.484\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnti-coagulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (7.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.262\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoagulopathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (0.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1 (0.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBleeding location\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeck\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10 (7.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0(0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.211\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChest\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23 (13.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16 (11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (21.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.145\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbdomen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e99 (56.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e75 (52.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24 (75.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.022*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePelvis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (14.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25 (17.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtremity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (15.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (9.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.419\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBleeding category\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28(16.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22 (15.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(18.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.651\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVisceral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46 (26.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38 (26.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (25.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWall\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48 (27.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41 (28.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (21.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.424\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRetroperitoneal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5 (3.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.020*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtremity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (16.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23 (16.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThoracic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8 (5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePulmonary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (1.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.459\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeck\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (5.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.214\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePresence of hematoma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (9.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (9.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (6.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.740\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e158 (90.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e128 (90.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e30 (93.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHematoma size\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmall\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e69 (43.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61 (47.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.037*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLarge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e89 (56.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e67 (52.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e22 (73.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtravasation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73 (42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62 (43.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11 (34.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.336\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e101 (58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80 (56.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e21 (65.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtravasation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003efree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e86 (85.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66 (82.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20 (95.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.185\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003econtained\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15 (14.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (17.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (4.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFree extravasation volume\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003emild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58 (67.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51 (77.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (35.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.0001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubstantial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (32.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15 (22.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (65.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of bleeding foci\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51 (37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43 (39.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.374\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53 (39.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43 (39.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10 (37.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (23.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17 (21.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5 (33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003eIndicates significant p-value.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe presence of hematoma on CT was not associated with increased mortality (p\u0026thinsp;=\u0026thinsp;0.740). However, the size of hematoma was linked to mortality with large hematomas associated with a higher mortality rate (73.3% of deceased had large hematomas, p\u0026thinsp;=\u0026thinsp;0.037).\u003c/p\u003e\u003cp\u003eContrast extravasation was more common in deceased individuals (65.6%), but this did not reach statistical significance (p\u0026thinsp;=\u0026thinsp;0.336). The volume of free extravasation was significantly associated with outcomes; substantial free extravasation was present in 65% of deceased cases (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The number of bleeding foci did not show a significant correlation with mortality (p\u0026thinsp;=\u0026thinsp;0.374).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eImpact of CT findings on Patient Survival\u003c/h2\u003e\u003cp\u003eKaplan-Meier curves were used to visualize the probability of survival over 28-day period for different clinical variables and used Log Rank (Mantel-Cox) Test Statistics for comparative analysis (supplemental material Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eKaplan-Meier estimates, depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA, revealed a divergence in survival probabilities between patients with small and large hematomas. The survival curve for patients with small hematomas consistently demonstrated superior survival over the 28-day period. This visual distinction was statistically significant (p\u0026thinsp;=\u0026thinsp;0.037). The presence of extravasation did not show a significant difference in survival outcomes with Kaplan-Meier survival curves (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB) following a similar trajectory (p\u0026thinsp;=\u0026thinsp;0.320).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFurther analysis of extravasation characteristics revealed no significant difference in survival between free versus contained extravasation (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eC) (p\u0026thinsp;=\u0026thinsp;0.162). However, when examining the impact of the volume of free extravasation on survival, Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eD showed a notable separation between the curves. Patients with minimal free extravasation had a higher probability of survival compared to those with substantial extravasation (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eMultivariate COX analysis\u003c/h2\u003e\u003cp\u003eThe Cox multivariate regression analysis was used to determine which significant variables are independently associated with an increased risk of mortality (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The presence of a substantial contrast extravasation was associated with an increased risk with a hazard ratio of 2.49 (95% CI: 1.17\u0026ndash;5.29, p\u0026thinsp;=\u0026thinsp;0.018). Similarly, anticoagulation therapy was associated with a higher risk, with a hazard ratio of 2.46 (95% CI: 1.18\u0026ndash;5.11, p\u0026thinsp;=\u0026thinsp;0.016). Elevated mean INR was also associated with a higher risk, with a hazard ratio of 3.73 (95% CI: 1.78\u0026ndash;7.82, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Lastly, the use of vasopressors was associated with the highest risk increase, with a hazard ratio of 4.91 (95% CI: 2.31\u0026ndash;10.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCox Regression Analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHazard Ratio (Exp(B))\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e95% Confidence Interval for Exp(B)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubstantial extravasation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.17\u0026ndash;5.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.018*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnticoagulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.18\u0026ndash;5.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.016*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean INR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.78\u0026ndash;7.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUse of Vasopressor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.31\u0026ndash;10.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Indicates significant p-value.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eInter-rater Reliability Analysis for Hematoma Size and active bleeding Assessment\u003c/h2\u003e\u003cp\u003eInter-rater Reliability Analysis is presented in supplemental material Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The inter-rater reliability for hematoma size was found to be substantial (kappa value of 0.668, 95% CI between 0.578 to 0.758, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). For the assessment of extravasation, the inter-rater reliability for the presence of extravasation was found to be almost perfect (kappa value of 0.867, 95% between 0.781 to 0.953, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) and almost perfect for free versus contained extravasation (kappa value of 0.838, 95% CI between 0.722 to 0.955 p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). For free extravasation volume the inter-rater reliability was substantial (kappa value of 0.694, 95% CI between 0.568 to 0.821, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn the evaluation of 28-day mortality predictors among patients undergoing CT angiography for suspected active bleeding, significant associations were identified with various factors. The study found that increased age, higher BMI, the presence of comorbidities in particular malignancy, and the use of anticoagulants, antiplatelets and/or thrombolytics were associated with higher mortality. Laboratory and hemodynamic parameters, including presence of hypotension, hypoxia, decreased hemoglobin, decreased platelet counts, high blood urea nitrogen, elevated INR, elevated lactate levels, decreased albumin, and elevated D-dimer levels, were also associated with increased mortality. Imagine findings, particularly the size of the hematoma, the extravasation volume, abdominal location specifically retroperitoneal bleeds were significantly associated with increased mortality. The need for platelets and FFPs transfusions and vasopressor use were also significantly associated with increased mortality. The Cox multivariate analysis showed that substantial active bleed, anticoagulation therapy, elevated mean INR and the use of vasopressors were independent predictors of mortality within 28 days.\u003c/p\u003e\u003cp\u003eThe study also shows that the type of intervention (including endoscopy, interventional radiology, surgery, or conservative management) did not significantly impact mortality rates.\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eCTA Bleeding characteristics\u003c/h2\u003e\u003cp\u003eSubstantial contrast extravasation was the only imaging finding independently associated with mortality. The Cox model showed that patients with substantial contrast extravasation had over a 2-fold increase in the risk of dying within 28 days. This indicates that the severity of bleeding plays a more critical role in determining patient outcomes than merely the presence of bleeding or the size of a hematoma. Our results are compatible with existing literature. Borror et al. showed increased mortality and transfusion requirements with patient with high rate of active bleed\u0026thinsp;\u0026gt;\u0026thinsp;20 cc/min [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Chomchalerm et al. showed that rapid active contrast extravasation (defined as \u0026gt;\u0026thinsp;450% increase in perimeter of extravasation between arterial and portovenous phases) was significantly associated with increased 24h mortality percentage (16.7%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.002) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Kaewlai et al. showed that extravasation length\u0026thinsp;\u0026gt;\u0026thinsp;8 mm was the only imaging marker independently predictive of in-hospital mortality (p\u0026thinsp;=\u0026thinsp;0.043) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. On the other hand, Khdhir et al. suggested that small bleeds, especially ones seen on delayed phases caries no diagnostic and possibly no clinical relevance [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The significance of extravasation volume likely stems from its capacity to represent the intensity of the bleeding episode, denoting present or impending hemodynamic instability. Still, the lack of independent predictive value for certain markers like hematoma size does not necessarily diminish their role in the evaluation of patients with suspected bleed, as these indicators still contribute critical information for initial diagnosis and management planning.\u003c/p\u003e\u003cp\u003eMoreover, although the reader agreeability was high, a precise quantification of extravasation volume is important to improve the accuracy of prognosis prediction.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eCoagulation profile and laboratory findings\u003c/h2\u003e\u003cp\u003eAntithrombotic therapies and mean INR were independently associated with over a 2-fold and 3- fold increase in mortality respectively. This is expected since these parameters serve as indicators of coagulopathy, which can exacerbate bleeding events [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The results are in accordance with existing literature, most recently, Kaewlai et al. who found that increased PTT was independently associated with mortality in patients undergoing abdominopelvic CT (p\u0026thinsp;=\u0026thinsp;0.005) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe original analysis showed an association between hypotension, hemoglobin level at presentation, and elevated lactate levels with 28-day mortality. Elevated lactate levels, indicates systemic hypoperfusion and end-organ ischemia leading to poor outcomes in acute bleeding and trauma patient[\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] even when adjusting for blood pressure [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Holstein et al. showed that non-survivors in patients with pelvic fractures had lower initial blood hemoglobin concentration (6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9 versus 9.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0 g/dL) and systolic arterial blood pressure (77\u0026thinsp;\u0026plusmn;\u0026thinsp;27 versus 106\u0026thinsp;\u0026plusmn;\u0026thinsp;24 mmHg) [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Marmo et al. showed independent association between hemoglobin level and mortality in patients with GI bleed [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Yoo Jin Lee et al found that hypotension during hospitalization in patients with GI bleed was associated with 30-day mortality in contrast to hemoglobin level which was not associated with mortality [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eType of intervention\u003c/h2\u003e\u003cp\u003eThe type of intervention (endoscopy, endovascular embolization, surgery, or conservative management) did not significantly affect mortality rates, suggesting that outcomes may be more influenced by the patient's clinical condition and the necessity for supportive care rather than the specific clinical management strategy. In the literature, a retrospective comparison of IR with surgery in patients with non-variceal upper gastrointestinal hemorrhage (NVUGIH) demonstrated equivalent mortality and clinical success despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. A meta-analysis by Tarasconi et al. found that, compared to surgery, TAE exhibits a higher rebleeding rate, but similar mortality rates in patients with NVUGIH [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. With regards to trauma setting, Forberg et al. found a significant increased risk of 30-day mortality (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04) in patients with active bleeding treated with explorative laparotomy and surgical packing compared to angiography and embolization [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Aoki et al. found no significant difference in hospital survival between embolization and laparotomy in patients with solid organ injury who responded to initial resuscitation [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOn the other hand, the necessity for supportive measures, in particular fresh frozen plasma, platelets, and vasopressors were indicative of a trend towards higher mortality. The need for vasopressors was independently associated with the highest risk increase with around 5-fold increased risk of mortality. This suggests that while the choice of intervention might not directly influence mortality, the severity of bleeding, as necessitated by the need for extensive hemodynamic support, can affect patient\u0026rsquo;s outcomes. This reiterates the need for rapid intervention to mitigate the progression into hemodynamic instability, in accordance with suggested guidelines [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This also necessitates preemptive measures to prevent the onset of hemodynamic instability. Additionally, procedural factors such as interventionist experience and number of bleeding foci may affect procedural time and should be considered when optimizing treatment planning [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThe retrospective design, single-center setting, and sample size may limit the generalizability of the findings. Additionally, the lack of focus on specific body regions makes the study broadly inclusive which may reduce its region-specific applicability. Future research should focus on prospective studies to validate these findings.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings indicate that sever hemodynamic instability, coagulation abnormalities, and contrast extravasation severity are critical determinants of 28-day mortality in patients with suspected active bleeding undergoing CTA. Notably the choice of intervention did not directly influence mortality rates, suggesting that outcomes may be more influenced by the patient's clinical condition and the necessity for supportive care rather than the specific clinical management strategy. This highlights the importance of early and accurate assessment of bleeding severity and underscores the need for rapid bleeding management and the implementation of preventive measures against hemodynamic instability. Future efforts should focus on creating standardized protocols that incorporate key predictors into the decision-making process for the management of bleeding patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eAuthors disclosure\u003c/h2\u003e\u003cp\u003eNone.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding source:\u003c/h2\u003e\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWortman JR, Landman W, Fulwadhva UP, Viscomi SG, Sodickson AD (2017) CT angiography for acute gastrointestinal bleeding: What the radiologist needs to know. Br J Radiol 90:1\u0026ndash;9\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCopland A, Munroe CA, Friedland S, Triadafilopoulos G (2010) Integrating urgent multidetector CT scanning in the diagnostic algorithm of active lower GI bleeding. Gastrointest Endosc 72:402\u0026ndash;405\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSoto JA, Anderson SW (2012) Multidetector CT of blunt abdominal trauma. Radiology 265:678\u0026ndash;693\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGould JE, Vedantham S (2006) The role of interventional radiology in trauma. Semin Intervent Radiol 23:270\u0026ndash;278\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTouma L, Cohen S, Cassinotto C, Reinhold C, Barkun A, Tran VT et al (2019) Transcatheter Arterial Embolization of Spontaneous Soft Tissue Hematomas: A Systematic Review. Cardiovasc Intervent Radiol 42:335\u0026ndash;343\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRossaint R, Afshari A, Bouillon B, Cerny V, Cimpoesu D, Curry N et al (2023) The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care 27:1\u0026ndash;45\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMaegele M (2019) The diagnosis and treatment of acute traumatic bleeding and coagulopathy. Dtsch Arztebl Int 116:799\u0026ndash;806\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCarvalho M, Rodrigues A, Gomes M, Carrilho A, Nunes AR, Orf\u0026atilde;o R et al (2016) Interventional algorithms for the control of coagulopathic bleeding in surgical, trauma, and postpartum settings: Recommendations from the Share Network Group. Clin Appl Thromb Hemost 22:121\u0026ndash;137\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKokabi N, Shuaib W, Xing M, Harmouche E, Wilson K, Johnson JO et al (2014) Intra-abdominal solid organ injuries: An enhanced management algorithm. Can Assoc Radiol J 65:301\u0026ndash;309\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTomaselli GF, Mahaffey KW, Cuker A, Dobesh PP, Doherty JU, Eikelboom JW et al (2020) 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 76:594\u0026ndash;622\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOakland K, Chadwick G, East JE, Guy R, Humphries A, Jairath V et al (2019) Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 68:776\u0026ndash;789\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEly JW, Kennedy CM, Clark EC, Bowdler NC (2006) Abnormal uterine bleeding: A management algorithm. J Am Board Fam Med 19:590\u0026ndash;602\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBorror W, Gaski GE, Steenburg S (2019) Abdominopelvic bleed rate on admission CT correlates with mortality and transfusion needs in the setting of blunt pelvic fractures: a single institution pilot study. Emerg Radiol 26:37\u0026ndash;44\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChomchalerm G, Kaewlai R, Tongsai S, Chatpuwaphat J, Thamtorawat S, Praditsuktavorn B et al (2025) Rapid, moderate, or slow bleeding? CT analysis of abdominopelvic active vascular contrast extravasation classes and mortality outcomes. Eur Radiol\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKaewlai R, Chomchalerm G, Tongsai S, Chatpuwaphat J, Chatkaewpaisal A, Khamman P et al (2024) Predictors and pathways of in-hospital mortality in active vascular contrast extravasation detected on abdominopelvic CT. Insights Imaging. ;15\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKhdhir M, Ghosn Y, Jabbour Y, Abbas N, Tarcha Z, Kayali M et al (2024) Does delayed phase imaging in CT angiography provide additional information in patients with suspected active bleeding? Emerg Radiol 31:439\u0026ndash;446\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGulen M, Satar S, Tas A, Avci A, Nazik H (2019) Toptas Firat B. Lactate Level Predicts Mortality in Patients with Upper Gastrointestinal Bleeding. Gastroenterol Res Pract. ;2019\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLee SH, Min YW, Bae J, Lee H, Min BH, Lee JH et al (2017) Lactate parameters predict clinical outcomes in patients with nonvariceal upper gastrointestinal bleeding. J Korean Med Sci 32:1820\u0026ndash;1827\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOdom SR, Howell MD, Silva GS, Nielsen VM, Gupta A, Shapiro NI et al (2013) Lactate clearance as a predictor of mortality in trauma patients. J Trauma Acute Care Surg 74:999\u0026ndash;1004\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHolstein JH, Culemann U, Pohlemann T (2012) What are predictors of mortality in patients with pelvic fractures? Trauma. Clin Orthop Relat Res 470:2090\u0026ndash;2097\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMarmo R, Koch M, Cipolletta L, Capurso L, Pera A, Bianco MA et al (2008) Predictive factors of mortality from nonvariceal upper gastrointestinal hemorrhage: A multicenter study. Am J Gastroenterol 103:1639\u0026ndash;1647\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSadiku E, Hoti K, Bruci A, Tac S, Bruci A, Kraja B (2023) Predictive Factors of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding. Int J Biomed 13:110\u0026ndash;116\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMirsadraee S, Tirukonda P, Nicholson A, Everett SM, McPherson SJ (2011) Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review. Clin Radiol 66:500\u0026ndash;509\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTarasconi A, Baiocchi GL, Pattonieri V, Perrone G, Abongwa HK, Molfino S et al (2019) Transcatheter arterial embolization versus surgery for refractory non-variceal upper gastrointestinal bleeding: A meta-analysis. World J Emerg Surg 14:1\u0026ndash;13\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFroberg L, Helgstrand F, Clausen C, Steinmetz J, Eckardt H (2016) Mortality in trauma patients with active arterial bleeding managed by embolization or surgical packing: An observational cohort study of 66 patients. J Emerg Trauma Shock 9:107\u0026ndash;114\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAoki M, Abe T, Hagiwara S, Saitoh D, Oshima K (2021) Embolization versus Surgery for Stabilized Patients with Solid Organ Injury. J Vasc Interv Radiol 32:1150\u0026ndash;1155e5\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGhosn Y, Khdhir M, Jabbour Y, Dushfunian D, Kobeissi I, Abbas N et al (2024) Factors affecting radiation dose, radiation exposure time and procedural time in arterial embolization for active hemorrhage. Emerg Radiol\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"American University of Beirut Medical Center","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Active bleeding, mortality","lastPublishedDoi":"10.21203/rs.3.rs-7390228/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7390228/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRational and Objective: This study aimed to identify predictors of 28-day mortality in patients with suspected active bleeding undergoing Computed Tomography Angiography (CTA).\u003c/p\u003e\n\u003cp\u003eMaterials and Methods: Retrospective analysis of patients who underwent multi-phasic CTA for suspected active bleeding at a major medical center between January 2019 and November 2021 was performed. The study assessed the association of demographic variables, laboratory data, CTA findings, and interventions performed with 28-day mortality. Statistical analyses included chi-square tests, t-tests, Cox Proportional Hazards Model, and Kaplan-Meier survival curves.\u003c/p\u003e\n\u003cp\u003eResults: A total of 174 patients were analyzed, showing an 18% (n=32) mortality rate within the 28-day period. Cox regression analysis showed that substantial contrast extravasation (HR: 2.49, 95% CI: 1.17 - 5.29, p = 0.018), anticoagulation therapy (HR: 2.46, 95% CI: 1.18 - 5.11, p = 0.016), mean INR (HR: 3.73, 95% CI: 1.78 - 7.82, p \u0026lt; 0.001), and vasopressors use (HR: 4.91, 95% CI: 2.31 - 10.41, p \u0026lt; 0.001) were independently associated with an increased risk of mortality. The type of intervention did not significantly affect mortality rates.\u003c/p\u003e\n\u003cp\u003eConclusion: Substantial contrast extravasation was the only imaging feature independently associated with increased mortality in patients with suspected active bleeding.\u003c/p\u003e","manuscriptTitle":"Prognostic Value of CT Angiography Findings in Patient with Suspected Active Bleeding","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-20 06:47:55","doi":"10.21203/rs.3.rs-7390228/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e2a8b8a-5859-4e74-991f-c0539dc9ea35","owner":[],"postedDate":"August 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":53256273,"name":"Nuclear Medicine \u0026 Medical Imaging"}],"tags":[],"updatedAt":"2025-08-20T06:47:55+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-20 06:47:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7390228","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7390228","identity":"rs-7390228","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}