Comparison of computed tomography findings with clinical risks factors for endoscopic therapy in upper gastrointestinal bleeding cases.

acute upper gastrointestinal hemorrhage computed tomography risk assessment

Journal

Journal of clinical biochemistry and nutrition
ISSN: 0912-0009
Titre abrégé: J Clin Biochem Nutr
Pays: Japan
ID NLM: 8700907

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 27 12 2018
accepted: 16 02 2019
entrez: 9 10 2019
pubmed: 9 10 2019
medline: 9 10 2019
Statut: ppublish

Résumé

Several risk scoring systems exist for acute upper gastrointestinal bleeding (UGIB). The clinical Rockall score (clinical RS) and the Glasgow-Blatchford score (GBS) are major risk scores that consider only clinical data. Computed tomography (CT) findings are equivocal in non-variceal UGIB. We compared CT findings with clinical data to predict mortality, rebleeding and need for endoscopic therapy in non-variceal UGIB patients. This retrospective, single-center study included 386 patients admitted to our emergency department with diagnosis of non-variceal UGIB by urgent endoscopy between January 2009 and March 2015. Multivariable logistic regression analysis was used to investigate CT findings and risk factors derived from clinical data. CT findings could not significantly predict mortality and rebleeding in non-variceal UGIB patients. However, upper gastrointestinal hemorrhage in CT findings better predicted the need for endoscopic therapy than clinical data. The adjusted odds ratios were 10.10 (95% CI 5.01-20.40) for clinical RS and 10.70 (95% CI 5.08-22.70) for the GBS. UGI hemorrhage in CT findings could predict the need for endoscopic therapy in non-variceal UGIB patients in our emergency department. CT findings as well as risk score systems may be useful for predicting the need for endoscopic therapy.

Identifiants

pubmed: 31592208
doi: 10.3164/jcbn.18-115
pii: DN/JST.JSTAGE/jcbn/18-115
pmc: PMC6769404
doi:

Types de publication

Journal Article

Langues

eng

Pagination

138-145

Informations de copyright

Copyright © 2019 JCBNCopyright © 2019 JCBN.

Déclaration de conflit d'intérêts

No potential conflicts of interest were disclosed.

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Auteurs

Fumitake Jono (F)

Department of Medical Education, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Hiroshi Iida (H)

Department of Hepatology and Gastroenterology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Koji Fujita (K)

Office of Postgraduate Medical Education, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Megumi Kaai (M)

Yokohama Hodogaya Central Hospital, 43-1, Kamadai-cho, Hodogaya-ku, Yokohama 240-8585, Japan.

Kenji Kanoshima (K)

Department of Hepatology and Gastroenterology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Kanji Ohkuma (K)

Department of Hepatology and Gastroenterology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Takashi Nonaka (T)

Department of Hepatology and Gastroenterology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Tomonori Ida (T)

Department of Medical Education, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Akihiko Kusakabe (A)

Office of Postgraduate Medical Education, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Atsushi Nakamura (A)

Department of Endoscopy and Gastroenterology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan.

Shigeru Koyama (S)

Department of Endoscopy and Gastroenterology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan.

Atsushi Nakajima (A)

Department of Hepatology and Gastroenterology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Masahiko Inamori (M)

Department of Medical Education, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

Classifications MeSH