Abstract
HTH-14 A multi-centre analysis of AUGIB; urea-creatinine ratiois a useful predictor for bleeding, and endotherapy
Gut, Vol.70(Suppl 4), pp.A37-A37
11/2021
DOI: 10.1136/gutjnl-2021-BSG.65
Abstract
IntroductionThe assessment of patients presenting with symptoms of acute upper GI bleed (AUGIB) is critical in determining if patients would benefit from a gastroscopy and endoscopically delivered therapy. The Rockall score, and superiorly, the Glasgow-Blatchford score (GBS) have been validated as effective risk tools for this purpose. The GBS considers serum urea levels, it established that digested blood from AUGIB causes a raised serum urea. This may be confounded by patients with kidney injury (acute, or acute on chronic) which may occur as a consequence of hypovolaemia in susceptible patients with AUGIB. There has been evidence that a urea creatinine ratio (UCR) may be useful identifying patients with a significant AUGIB.1 A preliminary analysis of 357 cases showed UCR - using a cut off of 97.7 was superior to serum urea (AUC 0.789 vs 0.733).2 MethodsWe collated data from 2203 presentations of AUGIB resulting in admission and an inpatient OGD within 72 hours, between January 2017 and January 2020, from 9 English centres. Data was recorded in a Microsoft Excel spreadsheet. We analysed serum urea levels, urea creatinine ratio (urea x 1000/creatinine), whether a plausible diathesis for AUGIB was seen, if endoscopic intervention was needed, and whether the patient had liver disease. Logistical regression was performed using SPSS.ResultsOf the 2203 presentations (mean age 65.2 years, median 68, range 16-101 years), 1194 had a plausible bleeding diathesis (54.2%), of this 1194, 721 had endoscopic therapy (60.4%). 296 patients had liver disease (13.4%) – of which 271 had a bleed (91.6%).Abstract HTH-14 Table 1 All With liver disease Without liver disease Endoscopic therapy Area under the curve (AUC ) 0.7235 0.7409 0.7031 0.664 Threshold value 101.6 86.1 101.6 101.2 Specificity 0.65 0.76 0.64 0.54 Sensitivity 0.70 0.72 0.73 0.73 ConclusionsThis large multicentre analyses of AUGIB cases have shown that UCR was a good indicator in AUGIB for patients who have a culprit lesion and required endoscopic therapy. It may be appropriate to use UCR as opposed to serum urea in patients with AUGIB when considering the need for endoscopic therapy.ReferencesSrygley FD, Gerardo CI, Tran T, Fisher DA. Does this patient have a severe upper gastrointestinal bleed?JAMA. 2012 Mar 14;307(10):1072-9.Kotecha D, Mak J, Sharma N, et al. PTU-072|A multi-centre review of acute upper GI bleeding; can blood urea levels aid diagnosis?Gut 2019;68:A153.
Details
- Title: Subtitle
- HTH-14 A multi-centre analysis of AUGIB; urea-creatinine ratiois a useful predictor for bleeding, and endotherapy
- Creators
- Solange Serna - Kettering General HospitalJonathan Segal - Imperial College Healthcare NHS TrustAbdullah Abbasi - Shrewsbury and Telford Hospital NHS TrustJunaid Aleem - University Hospitals Birmingham NHS Foundation TrustNoor Alhamamy - Good Hope HospitalJad Alkoury - Shrewsbury and Telford Hospital NHS TrustRaheel Anjum - The Royal Wolverhampton NHS TrustMr Benjamin Disney - University Hospitals Coventry and Warwickshire NHS TrustEmma Howard - Shrewsbury and Telford Hospital NHS TrustAaron Hundle - University Hospitals Birmingham NHS Foundation TrustNasir Hussain - Good Hope HospitalMr Asem Ismail - Sheffield Teaching Hospitals NHS Foundation TrustMichael McFarlane - Warwick HospitalElla Mozdiak - Good Hope HospitalSaskia Port - Good Hope HospitalDeepa Rattehalli - Dudley Group NHS Foundation TrustJohn Schembri - Sheffield Teaching Hospitals NHS Foundation TrustGeeth Silva - Kettering General HospitalMo Thoufeeq - Sheffield Teaching Hospitals NHS Foundation TrustAjay Verma - Kettering General Hospital
- Resource Type
- Abstract
- Publication Details
- Gut, Vol.70(Suppl 4), pp.A37-A37
- Publisher
- BMJ Publishing Group Ltd and British Society of Gastroenterology; LONDON
- DOI
- 10.1136/gutjnl-2021-BSG.65
- ISSN
- 0017-5749
- eISSN
- 1468-3288
- Language
- English
- Date published
- 11/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984843739002771
Metrics
1 Record Views