Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding  

作　　者：Minoru Tomizawa Fuminobu Shinozaki Rumiko Hasegawa Yoshinori Shirai Yasufumi Motoyoshi Takao Sugiyama Shigenori Yamamoto Naoki Ishige 

机构地区：[1]Department of Gastroenterology,National Hospital Organization Shimoshizu Hospital [2]Department of Radiology,National Hospital Organization Shimoshizu Hospital [3]Department of Surgery,National Hospital Organization Shimoshizu Hospital [4]Department of Neurology,National Hospital Organization Shimoshizu Hospital [5]Department of Rheumatology,National Hospital Organization Shimoshizu Hospital [6]Department of Pediatrics,National Hospital Organization Shimoshizu Hospital [7]Department of Neurosurgery,National Hospital Organization Shimoshizu Hospital

出　　处：《World Journal of Gastroenterology》2015年第20期6246-6251,共6页世界胃肠病学杂志（英文版）

摘　　要：AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix patients had upper GI bleeding(Upper group) and 65 had lower GI bleeding(Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiveroperator characteristic(ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin(P = 0.023), total protein(P = 0.0002), and lactate dehydrogenase(P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen(BUN) was higher in the Upper group than in the Lower group(P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vslower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/d L, with a specificity of 93.0%.CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/d L.AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix patients had upper GI bleeding(Upper group) and 65 had lower GI bleeding(Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiveroperator characteristic(ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin(P = 0.023), total protein(P = 0.0002), and lactate dehydrogenase(P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen(BUN) was higher in the Upper group than in the Lower group(P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vslower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/d L, with a specificity of 93.0%.CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/d L.

关 键 词：LOGISTIC regression ANALYSIS Likelihoodanalysis Receiver-operator characteristic ANALYSIS Blood URINE nitrogen HEMOGLOBIN 

分 类 号：R57[医药卫生—消化系统]