Keser AG, et al. - This study was designed to ascertain the risk factors predicting clinically significant gastrointestinal (GIS) bleeding in patients presenting to Pediatric Emergency Department (PED). Findings highlighted the significance of the knowledge regarding clinical and laboratory parameters of patients with clinically significant GIS bleeding for identifying patients at risk of life threatening blood loss in PED. Significant GIS bleeding risk was observed for patients who have melena, pallor, tachycardia, anemia and uremia at presentation.

Methods

• Researchers performed a prospective study from January 1st 2013 to December 31th 2013 in patients with upper or lower GIS bleeding.
• They defined clinically significant GIS bleeding as more than 2 gr/dL hemoglobin decrease at any time during observation in PED, need for erythrocyte tranfusion or need for rapid endoscopic evaluation.

Results

• Researchers enrolled 105 patients; 81 of these were eligible.
• Clinically significant GIS bleeding was observed in 22 patients (26,8%).
• Significantly more common upper GI bleeding and symptoms of melena, pallor and tachycardia were observed in these patients.
• In these patients, initial laboratory findings indicated lower hemoglobin, RBC and albumin levels with higher WBC and BUN levels.
• Significantly more nasogastric tube placement and PPI and H2 blocker treatment were required by these patients.
• Gastritis and peptic ulcers were more frequently noticed as the final diagnosis.
• They noticed less hematochesia and less lower gastrointestinal bleeding in these patients.
• These patients were less commonly diagnosed as acute gastroenteritis or Mallory Weiss tear as a final diagnosis.