Analysis of risk factors and development of scoring system to predict severity of upper gastrointestinal bleeding in children. Issue 6 (21st December 2018)

• Record Type: Journal Article
• Authors: Zheng, Wei; Jiang, Linmei; Jia, Xinyi; Long, Gao; Shu, Xiaoli; Jiang, Mizu
• Is Part Of: Journal of gastroenterology and hepatology. Volume 34:Issue 6(2019)
• Page Start: 1035
• Page End: 1041
• Publication Date: 2018-12-21
• Subjects: children -- risk factors -- scoring system -- upper gastrointestinal bleeding; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14548
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: 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.