Predictors of Clinically Significant Upper Gastrointestinal Hemorrhage Among Children With Hematemesis
Journal of Pediatric Gastroenterology and Nutrition,

Freedman SB et al. – The occurrence of a clinically significant upper gastrointestinal hemorrhage (UGIH) was uncommon among children with hematemesis, especially in well–appearing children without melena, hematochezia, or who had not vomited a moderate to large amount of fresh blood.

Methods
  • A retrospective cohort study was conducted.
  • All of the emergency department visits by children ages 0 to 18 years who presented with hematemesis between 2000 and 2007 were reviewed.
  • The primary aim of the study was to determine the proportion of children who developed a clinically significant UGIH; the secondary aim was to identify risk factors predictive of a clinically significant UGIH.
  • A significant UGIH was defined by any of the following: hemoglobin drop >20g/L, blood transfusion, or emergent endoscopy or surgical procedure.

Results
  • Twenty-seven of 613 eligible children (4%; 95% confidence interval 3%–6%) had a clinically significant UGIH.
  • The frequency of laboratory investigations increased with age (P<0.001).
  • The hemoglobin level was the only laboratory investigation whose results differed between those with and without significant bleeds.
  • The presence of any one of the following characteristics identified all of the children with a clinically significant hemorrhage: melena, hematochezia, unwell appearance, or a moderate to large volume of fresh blood in the vomitus, sensitivity 100% (95% confidence interval 85%–100%).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Physician Assistant

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Physician Assistant Articles

1 Dance for Parkinson's: A new framework for research on its physical, mental, emotional, and social benefits Complementary Therapies in Medicine, June 17, 2014    Review Article

2 Statins in the elderly: an answered question Current Opinion in Cardiology, June 9, 2014    Evidence Based Medicine    Review Article    Clinical Article

3 Efficacy of high-dose versus standard-dose influenza vaccine in older adults New England Journal of Medicine, August 15, 2014    Evidence Based Medicine    Clinical Article

4 Hepatitis a hospitalizations in the United States, 2002 – 2011 Hepatology, October 3, 2014    Clinical Article

5 A statin a day to keep the doctor away? comparing aspirin and statins for primary prevention of cardiovascular disease Annals of Pharmacotherapy, August 7, 2014    Clinical Article

6 Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States BMJ, June 24, 2014    Evidence Based Medicine    Clinical Article

7 Consumption of nuts and legumes and risk of stroke: a meta-analysis of prospective cohort studies Nutrition, Metabolism & Cardiovascular Diseases, July 25, 2014    Evidence Based Medicine    Clinical Article

8 Hemoglobin A1c levels and risk of severe hypoglycemia in children and young adults with type 1 diabetes from Germany and Austria: a trend analysis in a cohort of 37,539 patients between 1995 and 2012 Full Text PLoS Medicine, October 10, 2014    Free full text    Evidence Based Medicine    Clinical Article

9 Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial JAMA, October 10, 2014    Evidence Based Medicine    Clinical Article

10 The effectiveness of metoprolol versus atenolol on prevention of all-cause and cardiovascular mortality in a large Chinese population: A cohort study International Journal of Cardiology, June 27, 2014    Clinical Article

11 Vitamin E and C supplementation and risk of cancer in men: posttrial follow-up in the Physicians’ Health Study II randomized trial American Journal of Clinical Nutrition, July 10, 2014    Clinical Article

12 The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: Results of a randomized trial American Heart Journal, October 3, 2014    Clinical Article

13 Meta-analysis of non-steroidal anti-inflammatory drug use and risk of atrial fibrillation The American Journal of Cardiology, October 3, 2014    Evidence Based Medicine    Review Article    Clinical Article

14 Switching from allopurinol to febuxostat for the treatment of hyperuricemia and renal function in patients with chronic kidney disease Clinical Rheumatology, October 10, 2014    Clinical Article

15 Calcium channel blocker compared with angiotensin receptor blocker for patients with hypertension: a meta-analysis of randomized controlled trials The Journal of Clinical Hypertension, August 13, 2014    Evidence Based Medicine    Review Article    Clinical Article

16 Cardiac dysfunction associated with a nucleotide polymerase inhibitor for treatment of hepatitis C Hepatology, October 3, 2014    Clinical Article

17 Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children The Journal of Allergy and Clinical Immunology, October 10, 2014    Clinical Article

18 The management of cirrhosis in women Alimentary Pharmacology and Therapeutics, October 10, 2014    Review Article

19 Randomized comparison of gemcitabine, dexamethasone, and cisplatin versus dexamethasone, cytarabine, and cisplatin chemotherapy before autologous stem-cell transplantation for relapsed and refractory aggressive lymphomas: NCIC-CTG LY.12 Journal of Clinical Oncology, October 17, 2014    Clinical Article

20 Management of high-grade gliomas in the elderly Seminars in Radiation Oncology, October 3, 2014    Clinical Article

Indexed Journals in Physician Assistant: Advance for Physicians Assistants, American Family Physicianmore