title: Role of clinical parameters for predicting the cause of upper gastrointestinal bleeding.
abstract: BACKGROUND
  Upper gastrointestinal bleeding (UGIB) has been classified into portal and non-portal hypertension (PHT) bleeding causes. Differentiating the two major categories of UGIB is therefore important for selection of the appropriate empirical treatment.
  
  
  OBJECTIVE
  To evaluate the potential of certain clinical parameters for predicting the cause of UGIB.
  
  
  METHODS
  The records of patients with UGIB who underwent endoscopy within 72 hours of diagnosis were retrospectively examined for the clinical parameters. Potential predictive factors for categorizing the cause of UGIB were identified by univariate and multivariate analysis.
  
  
  RESULTS
  One hundred forty six UGIB patients were enrolled in the present study. One hundred nine patients had non-PHT bleeding and 37 patients were PHT bleeding. Multivariate analysis identified three independent factors for predicting PHT bleeding, presence of signs of chronic liver disease or PHT (Odds ratio (OR) 51.1, p < 0.05), presence of underlying cirrhosis (OR 28.4, p < 0.05) and an initial hematocrit < 30% (OR 12.7, p < 0.05). A presentation with coffee ground vomitus was the only factor that indicated a reduced possibility of PHT bleeding (OR 0.1, p < 0.05).
  
  
  CONCLUSIONS
  The presence of underlying cirrhosis, signs of chronic liver disease or portal hypertension and an initial hematocrit < 30% were significantly correlated with PHT bleeding while the presentation of coffee ground vomitus indicated a less likely chance of PHT bleeding.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Hat Yai Hospital, Songkhla, Thailand. a_rattanasupar@windowslive.com
authors.forename: Attapon
authors.initials: A
authors.lastname: Rattanasupar
mesh_terms: D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006400:Hematocrit; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008107:Liver Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D041742:Upper Gastrointestinal Tract