Predictors of Variceal Cause of Upper Gastrointestinal Tract Hemomhage

Authors

  • Panuwat Lertsithichai Department of Surgery, Ramathibodi Hospital and Medical School, Mahidol University, Bangkok, Thailand
  • Suwat Tangkittimasak Department of Surgery, Ramathibodi Hospital and Medical School, Mahidol University, Bangkok, Thailand
  • Preeda Sumritpradit Department of Surgery, Ramathibodi Hospital and Medical School, Mahidol University, Bangkok, Thailand

Abstract

Objective: To identify significant pre-endoscopic predictors of variceal cause in patients with acute upper gastrointestinal tract (GI) hemorrhage.

Patients and Methods: Medical records of 187 patients with primary diagnosis of upper GI hemorrhage treated during the period from May 2003 to July 2004 were reviewed. Predictors studied included age, sex, history of chronic liver disease, physical findings of chronic liver disease, abnormal laboratory findings and blood transfusion requirements prior to endoscopy. The outcome was the presence of variceal cause of upper GI hemorrhage on urgent upper GI endoscopy. Predictors were individually tested for statistical association with endoscopic findings using chi-square, t-test and Wilcoxon rank-sum test, and entered into a multiple logistic regression analysis. The final logistic regression model was tested for discriminatory ability using the Area Under the receiver operating characteristic Curve (AUC) and cross validation was performed using the jackknife method.

Results: The prevalence of variceal cause of upper GI hemorrhage was 14% (27/187), Only documented history of chronic liver disease (OR: 51.8, 95% CI: 15.1 to 177.3) and low platelet count (1.9 per 100,000 decrease; 95 % CI: 1.0 to 3.3) were significant independent predictors of variceal cause of upper GI hemorrhage. The AUC was 0.921 and the jackknife AUC was 0.892.

Conclusions: Documented history of chronic liver disease and low platelet count were independent predictors of variceal cause of upper GI hemorrhage. Patients with bleeding varices can be identified, to a certain extent, prior to upper GI endoscopy.

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Published

2005-03-31

How to Cite

1.
Lertsithichai P, Tangkittimasak S, Sumritpradit P. Predictors of Variceal Cause of Upper Gastrointestinal Tract Hemomhage. Thai J Surg [Internet]. 2005 Mar. 31 [cited 2024 Apr. 19];26(1):1-4. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242179

Issue

Vol. 26 No. 1 (2005): January - March

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.