Witting Michael D, Magder Laurence, Heins Alan E, Mattu Amal, Granja Carlos A, Baumgarten Mona
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Am J Emerg Med. 2006 May;24(3):280-5. doi: 10.1016/j.ajem.2005.11.005.
In patients with gastrointestinal (GI) tract bleeding, the bleeding source is uncertain in the absence of hematemesis. We sought to identify clinical variables predictive of an upper GI bleeding source.
This retrospective cohort study involved patients admitted via the ED for GI tract bleeding without hematemesis, who underwent confirmatory testing. We used logistic regression analysis to identify clinical variables independently associated with an upper GI source.
Among 325 patients, odds ratios for the strongest predictors were as follows: black stool, 16.6 (95% confidence interval [CI], 7.7-35.7); age less than 50 years, 8.4 (95% CI, 3.2-22.1); and blood urea nitrogen/creatinine ratio 30 or greater, 10.0 (95% CI, 4.0-25.6). Seven (5%) of 151 with none of these factors had an upper GI tract bleed, versus 63 (93%) of 68 with 2 or 3 factors.
Black stool, age less than 50 years, and blood urea nitrogen/creatinine ratio of 30 or greater independently predict an upper GI tract bleeding source.
在无呕血的胃肠道（GI）出血患者中，出血来源尚不确定。我们试图确定可预测上消化道出血来源的临床变量。
这项回顾性队列研究纳入了因胃肠道出血且无呕血而通过急诊科入院并接受确诊检查的患者。我们使用逻辑回归分析来确定与上消化道出血来源独立相关的临床变量。
在325例患者中，最强预测因素的比值比分别如下：黑便，16.6（95%置信区间[CI]，7.7 - 35.7）；年龄小于50岁，8.4（95%CI，3.2 - 22.1）；血尿素氮/肌酐比值≥30，10.0（95%CI，4.0 - 25.6）。151例无上述任何因素的患者中有7例（5%）发生上消化道出血，而68例有2项或3项因素的患者中有63例（93%）发生上消化道出血。
黑便、年龄小于50岁以及血尿素氮/肌酐比值≥30可独立预测上消化道出血来源。
