The predictive value of the urea/hemoglobin ratio for endoscopic treatment in patients with upper gastrointestinal bleeding

Authors : Bayram Yeşil, Bünyamin Sevim

Pages : 499-504

Doi:10.47582/jompac.1350147

View : 97 | Download : 86

Publication Date : 2023-10-27

Article Type : Research Paper

Abstract :Abstract Aims: Upper gastrointestinal bleeding develops due to various pathologies in a wide region, including esophagus, stomach, and duodenum. The clinical presentation is highly variable between patients and can rapidly deteriorate and even be fatal without follow-up. Medical agents, endoscopic interventions, and surgery may be required in the treatment of the patient, and a high blood transfusion may be required. Predicting which patients are more at risk and urgent than others is important for the correct treatment of patients. The urea/hemoglobin ratio can be a simple, rapidly applicable, and reliable indicator to predict the need for endoscopy. Methods: This was a single-center retrospective study in which 361 patients treated for upper gastrointestinal bleeding were investigated. Age and gender data, endoscopy records, and blood tests of the patients were analyzed within the scope of the study. Median UHR values were significantly higher in intensive care indication, endoscopic indications, and blood transfusion indications (p<0.05). Results: The majority of patients were male, with 72.3%. The median age was 56 years (15-96). Peptic ulcer (70.9%) was the most common etiologic cause, and angioectasia (6.65%) was the second most common etiologic cause. Intensive care follow-up was required in 29.1%, erythrocyte replacement in 36.01%, and endoscopic treatment in 46.81% of patients. 13 patients died (3.6%). The median value was 58 for urea, 10.50 for hemoglobin and 5.75 for UHR. Conclusion: Upper gastrointestinal bleeding is a variable and rapidly deteriorating clinical entity. Patients may not always be encountered under ideal conditions and may need to be managed with limited resources. Therefore, there is a need for easy-to-access, rapid, and reliable auxiliary techniques to differentiate patients who may need urgent treatment and interventions from others. Urea and Urea/hemoglobin ratio fulfill these requirements, and their significance in terms of upper gastrointestinal bleeding should be investigated.
Keywords : Üst gastrointestinal sistem kanaması, acil müdahale, endoskopi, üre, kan üre azotu, prognoz

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