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World J Gastroenterol. 2014 Feb 7;20(5):1311-7. doi: 10.3748/wjg.v20.i5.1311.

Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding.

Author information

1
Minoru Tomizawa, Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan.

Abstract

AIM:

To investigate the early upper gastrointestinal endoscopy (endoscopy) significantly reduces mortality resulting from upper gastrointestinal (GI) bleeding.

METHODS:

Upper GI bleeding was defined as 1a, 1b, 2a, and 2b according to the Forrest classification. The hemoglobin (Hb), and C-reactive protein (CRP) were examined at around the day of endoscopy and 3 mo prior to endoscopy. The rate of change was calculated as follows: (the result of blood examination on the day of endoscopy - the results of blood examination 3 mo prior to endoscopy)/(results of blood examination 3 mo prior to endoscopy). Receiver operating characteristic curves were created to determine threshold values.

RESULTS:

Seventy-nine men and 77 women were enrolled. There were 17 patients with upper GI bleeding: 12 with a gastric ulcer, 3 with a duodenal ulcer, 1 with an acute gastric mucosal lesion, and 1 with gastric cancer. The area under the curve (AUC), threshold, sensitivity, and specificity of Hb around the day of endoscopy were 0.902, 11.7 g/dL, 94.1%, and 77.1%, respectively, while those of CRP were 0.722, 0.5 mg/dL, 70.5%, and 73%, respectively. The AUC, threshold, sensitivity, and specificity of the rate of change of Hb were 0.851, -21.3%, 76.4%, and 82.6%, respectively, while those of CRP were 0.901, 100%, 100%, and 82.5%, respectively.

CONCLUSION:

Predictors for upper GI bleeding were Hb < 11.7 g/dL, reduction rate in the Hb > 21.3% and an increase in the CRP > 100%, 3 mo before endoscopy.

KEYWORDS:

Area under curve; Gastrointestinal bleeding; Receiver operating characteristic; Sensitivity; Specificity

PMID:
24574805
PMCID:
PMC3921513
DOI:
10.3748/wjg.v20.i5.1311
[Indexed for MEDLINE]
Free PMC Article

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