title: How to differentiate sites of gastrointestinal bleeding in patients with hematochezia by using clinical factors?
abstract: Hematochezia is one of common gastrointestinal complaint at the Emergency Department (ED). Causes may be due to upper (UGIB) or lower (LGIB) gastrointestinal tract bleeding. Here, clinical factors were studied to differentiate sites of bleeding in patients with hematochezia. All patients with an age of more than 18 years who were diagnosed with GIB at the ED, Ramathibodi Hospital, Thailand were enrolled. Patients who presented with hematochezia and received complete workups to identify causes of bleeding were studied and categorized as being in the UGIB or LGIB groups. There were 1,854 patients who presented with GIB at the ED. Of those, 76 patients presented with hematochezia; 30 patients were in the UGIB group, while 43 patients were in the LGIB group. Clinical variables between both groups were mostly comparable. Three clinical factors were significantly associated with UGIB causes in patients with hematochezia including systolic blood pressure, hematocrit level, and BUN/Cr ratio. The adjusted odds ratios for all three factors were 0.725 (per 5 mmHg increase), 0.751 (per 3% increase), and 1.11 (per unit increase). Physicians at the ED could use these clinical factors as a guide for further investigation in patients who presented with hematochezia.
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Yuwares
authors.initials: Y
authors.lastname: Sittichanbuncha
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Suthasinee
authors.initials: S
authors.lastname: Senasu
authors.affiliation: Department of Computer Sciences, Faculty of Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
authors.forename: Theerayut
authors.initials: T
authors.lastname: Thongkrau
authors.affiliation: Department of Computer Sciences, Faculty of Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
authors.forename: Chaiyapon
authors.initials: C
authors.lastname: Keeratikasikorn
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand ; Research and Training Center for Enhancing Quality of Life of Working-Age People, Khon Kaen University, Khon Kaen 40002, Thailand.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth