Abstract :
Background:
Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal emergency. In the
Methods:
were collected prospectively. The associations between each factors and the final diagnosis of UGIB were
assessed using univariate and multivariate analysis. Model of a predicting score to predict the type of UGIB was
developed.
All patients with UGIB underwent EGD within 72 hours. Clinical and basic laboratory parameters
Results:
(18%) were variceal and 214 (82%) were nonvariceal bleeding. Univariate analysis identified 27 distinct parameters
associated with the types of UGIB. A stepwise logistic regression analysis identified 3 variables as independent
factors to predict types of UGIB; previous diagnosis of cirrhosis or presence of signs of chronic liver disease
(OR 22.4, 95% CI 8.3-60.4), red or bloody vomitus (OR 4.6, 95% CI 1.7-11.9), and red or bloody NG aspirate (OR
3.3, 95% CI 1.3-8.3). Variceal bleeding predicting scoring model was developed as: Z =
cirrhosis or presence of signs of chronic liver disease)
NG aspirate)
of variceal bleeding is calculated from 1/(1+e -Z) or by plotting to the exponential graph. The probabilities of
variceal bleeding are >90%, >60%, <10% and <5% for the presence of 3, 2, 1 and 0 factors, respectively.
Two hundreds and sixty-one patients with UGIB were enrolled into the study. Of these, 47(3.1 ~ previously diagnosed+ (1.4 ~ red or bloody vomitus) + (1.2 ~ red or bloody- 4.1, while 1 and 0 are used for the presence and absence of each factor, respectively. The probability
Conclusion:
types of UGIB and may aid clinical judgment for the initial management of UGIB before endoscopy.
Three clinical parameters and variceal bleeding predicting score are useful to predict the
[Thai J Gastroenterol 2007; 8(2): 44-50]
place where urgent esophagogastroduodenoscopy (EGD) is unavailable, empirical pharmacological therapy with
vasoactive drugs for variceal bleeding or proton pump inhibitors for nonvariceal bleeding is recommended. However,
the values of using clinical data for predicting the types of UGIB are unclear. The aim of this study is to
determine the values and efficacy of clinical and basic laboratory parameters in predicting the types of UGIB. |
file/Thai-Journal-of-gastroenterology-vol-8-no-2-2884296.pdf