Han Hee Lee1, Jae Myung Park2, Soon-Wook Lee1, Seung Hun Kang1, Chul-Hyun Lim1, Yu Kyung Cho1, Bo-In Lee1, In Seok Lee1, Sang Woo Kim1, Myung-Gyu Choi1. 1. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: parkjerry@catholic.ac.kr.
Abstract
BACKGROUND: In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. AIM: To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. METHODS: This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. RESULTS: A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. CONCLUSIONS: The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding.
BACKGROUND: In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. AIM: To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. METHODS: This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. RESULTS: A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. CONCLUSIONS: The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding.
Authors: Min Seob Kwak; Jae Myung Cha; Yong Jae Han; Jin Young Yoon; Jung Won Jeon; Hyun Phil Shin; Kwang Ro Joo; Joung Il Lee Journal: J Korean Med Sci Date: 2016-10 Impact factor: 2.153
Authors: Vera Hoffmann; Henrik Neubauer; Julia Heinzler; Anna Smarczyk; Martin Hellmich; Andrea Bowe; Fabian Kuetting; Muenevver Demir; Agnes Pelc; Sigrid Schulte; Ullrich Toex; Dirk Nierhoff; Hans-Michael Steffen Journal: Medicine (Baltimore) Date: 2015-09 Impact factor: 1.817