PREDICTIVE VALUE OF PLASMA UREA: CREATININE RATIO IN PATIENTS PRESENTING WITH MELAENA

Area of Science:

• Gastroenterology
• Clinical Diagnostics

Background:

• Melaena, or dark, sticky feces, indicates gastrointestinal bleeding.
• Determining the bleeding source is crucial for effective treatment.

Purpose of the Study:

• To evaluate the plasma urea:creatinine ratio's effectiveness in predicting the bleeding site in patients with melaena.

Main Methods:

• Studied 40 patients admitted with melaena.
• Excluded patients with frank hematemesis or undetermined bleeding sources.
• Analyzed plasma urea:creatinine ratios in relation to bleeding location (upper vs. lower GI tract).

Main Results:

• Upper GI bleeding occurred in 26 patients; lower GI bleeding in 14.
• A urea:creatinine ratio > 36 was found in 84.6% of upper GI bleeding cases.
• Only 2 patients (14.3%) with lower GI bleeding had a ratio > 36 (p < 0.001).

Conclusions:

• The plasma urea:creatinine ratio is a valuable, non-invasive tool for predicting upper gastrointestinal bleeding.
• A ratio of 36 or greater demonstrates high positive predictive value for upper GI bleeding.