title: Factors that affect visibility during endoscopic hemostasis for upper GI bleeding: a prospective study.
abstract: BACKGROUND
  Adequate visibility is an important factor for achieving successful endoscopic hemostasis for the treatment of upper GI bleeding (UGIB). The independent factors that affect visibility during endoscopic procedures have yet to be determined.
  
  
  OBJECTIVE
  To determine the factors that affect endoscopic visibility and to create a model that can predict in which patients unacceptable visibility is suspected before emergent endoscopic procedures for UGIB.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  University-affiliated tertiary care hospital in South Korea.
  
  
  METHODS
  A total of 121 patients admitted because of UGIB.
  
  
  METHODS
  Analysis of the visibility score of the emergency endoscopies for UGIB.
  
  
  METHODS
  Factors affecting the visibility score of endoscopy and a classification and regression tree (CART) model for predicting of visibility.
  
  
  RESULTS
  The EGD time and the appearance of the nasogastric (NG) tube aspirate were independent factors that were significantly associated with visibility (EGD time, P<.001; red blood appearance in NG tube aspirate, P<.001; coffee grounds appearance of NG tube aspirate, P=.006). Based on these results, a CART model was developed by using 70 patients who had been allocated to the training set. The CART generated algorithms that proposed the use of the appearance of the NG tube aspirate and the EGD time (8.5 hours) to predict visibility. The sensitivity and specificity for predicting poor visibility were 71.4% and 86.4%, respectively.
  
  
  CONCLUSIONS
  The use of the CART model enables the prediction of which patients will have poor visibility during emergent endoscopy.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sungmo
authors.initials: S
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ha Yan
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yun Ho
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Chan Hyuk
authors.initials: CH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hyunsoo
authors.initials: H
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Beom Kyung
authors.initials: BK
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hyuk
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Hong
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea; D055815:Young Adult