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Analysis of risk factors and development of scoring system to predict severity of upper gastrointestinal bleeding in children
Author(s) -
Zheng Wei,
Jiang Linmei,
Jia Xinyi,
Long Gao,
Shu Xiaoli,
Jiang Mizu
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14548
Subject(s) - medicine , hematochezia , etiology , upper gastrointestinal bleeding , retrospective cohort study , gastrointestinal bleeding , logistic regression , gastroenterology , cohort , endoscopy , colonoscopy , colorectal cancer , cancer
Background and Aim Upper gastrointestinal bleeding is a rare and potentially life‐threatening condition in children. Herein, clinical features and risk factors in children with upper gastrointestinal bleeding were analyzed, and a clinical scoring system was constructed to assess severity. Methods This retrospective cohort study involved 224 children hospitalized with upper gastrointestinal bleeding between January 2012 and April 2018. Demographic data, clinical information, and laboratory test results on admission were statistically examined. Results Out of 224 upper gastrointestinal bleeding cases, 76 were diagnosed as severe and 148 as mild cases according to the rate of blood loss and severity. Severe group was significantly different from mild group in 23 items including age, number of patients aged more than 7 years, and so forth ( P < 0.01 or P < 0.05). Positive detection rate of bleeding etiology was gradually decreased ( P < 0.01) in relation to delay in timing of endoscopy. Analysis of logistic regression evinced five independent risk factors for severe cases to be associated with poor consciousness, hemoglobin < 80 g/L, hemoglobin drop of > 20 g/L, hematochezia, and anemic appearance ( P < 0.01 or P < 0.05). Using these five parameters, a number of scoring models were tested. The most predictive resulted in a scoring system constructed with a total of 16 and a cutoff for intervention of 8. Conclusions Amalgamation of risk factors with the scoring system plays an important role in assessing upper gastrointestinal bleeding severity in children.