Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb 7;20(5):1311-7.
doi: 10.3748/wjg.v20.i5.1311.

Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding

Affiliations

Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding

Minoru Tomizawa et al. World J Gastroenterol. .

Abstract

Aim: To investigate the early upper gastrointestinal endoscopy (endoscopy) significantly reduces mortality resulting from upper gastrointestinal (GI) bleeding.

Methods: Upper GI bleeding was defined as 1a, 1b, 2a, and 2b according to the Forrest classification. The hemoglobin (Hb), and C-reactive protein (CRP) were examined at around the day of endoscopy and 3 mo prior to endoscopy. The rate of change was calculated as follows: (the result of blood examination on the day of endoscopy - the results of blood examination 3 mo prior to endoscopy)/(results of blood examination 3 mo prior to endoscopy). Receiver operating characteristic curves were created to determine threshold values.

Results: Seventy-nine men and 77 women were enrolled. There were 17 patients with upper GI bleeding: 12 with a gastric ulcer, 3 with a duodenal ulcer, 1 with an acute gastric mucosal lesion, and 1 with gastric cancer. The area under the curve (AUC), threshold, sensitivity, and specificity of Hb around the day of endoscopy were 0.902, 11.7 g/dL, 94.1%, and 77.1%, respectively, while those of CRP were 0.722, 0.5 mg/dL, 70.5%, and 73%, respectively. The AUC, threshold, sensitivity, and specificity of the rate of change of Hb were 0.851, -21.3%, 76.4%, and 82.6%, respectively, while those of CRP were 0.901, 100%, 100%, and 82.5%, respectively.

Conclusion: Predictors for upper GI bleeding were Hb < 11.7 g/dL, reduction rate in the Hb > 21.3% and an increase in the CRP > 100%, 3 mo before endoscopy.

Keywords: Area under curve; Gastrointestinal bleeding; Receiver operating characteristic; Sensitivity; Specificity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Receiver operating characteristic curves of the results of blood examination around the date of endoscopy. Receiver operating characteristic curves were created based on the results of blood examination around the day of endoscopy. The analyzed data were white blood cell count (A), hemoglobin (B), C-reactive protein (C), blood urea nitrogen (D), and creatinine (E), and blood urea nitrogen/creatinine (F). Solid straight line, a line with a slope of 45° to calculate threshold by the software (JMP 8.0.2); broken line, reference line.
Figure 2
Figure 2
Receiver operating characteristic curves of the results of change rate of blood examination. Receiver operating characteristic curves were created based on the rate of change in the results of blood examination. The rate of change rate was calculated as a comparison between around the day of endoscopy and 3 mo prior to the date of endoscopy (see text). The analyzed data were white blood cell count (A), hemoglobin (B), C-reactive protein (C), blood urea nitrogen (D), and creatinine (E). Solid straight line, a line with a slope of 45° to calculate threshold by the software (JMP 8.0.2); broken line, reference line.

Similar articles

Cited by

References

    1. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107:345–360; quiz 361. - PubMed
    1. Longstreth GF. Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol. 1995;90:206–210. - PubMed
    1. Kim SY, Hyun JJ, Jung SW, Lee SW. Management of non-variceal upper gastrointestinal bleeding. Clin Endosc. 2012;45:220–223. - PMC - PubMed
    1. Ljubicic N, Budimir I, Biscanin A, Nikolic M, Supanc V, Hrabar D, Pavic T. Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding. World J Gastroenterol. 2012;18:2219–2224. - PMC - PubMed
    1. Wilkins T, Khan N, Nabh A, Schade RR. Diagnosis and management of upper gastrointestinal bleeding. Am Fam Physician. 2012;85:469–476. - PubMed

MeSH terms