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

作     者：Minoru Tomizawa Fuminobu Shinozaki Rumiko Hasegawa Akira Togawa Yoshinori Shirai Noboru Ichiki Yasufumi Motoyoshi Takao Sugiyama Shigenori Yamamoto Makoto Sueishi 

作者机构：Department of Gastroenterology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Radiology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Surgery National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Neurology National Hos- pital Organization Shimoshizu Hospital Yotsukaido City Department of Rheumatology National Hospital Organization Shimoshizu Hospital Yotsukaido City Department of Pediatrics National Hospital Organization Shimoshizu Hospital Yotsukaido City 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第5期

页      面：1311-1317页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Receiver operating characteristic Area under curve 

摘      要：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 21.3% and an increase in the CRP 100%, 3 mo before endoscopy.