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Clinical Predictors of Gastrointestinal Bleeding Source before Computed Tomography Angiography
Wisam Sbeit1,2, Maamoun Basheer1,2, Amir Shahin1,2
1Department of Gastroenterology, Galilee Medical Center, Nahariya 221001, Israel.
Journal of Clinical Medicine
|December 23, 2023
Summary
High INR and low albumin levels strongly predict active gastrointestinal bleeding (GIB) detected by computed tomography angiography (CTA). Patients with high ASA scores were not associated with increased rates of active GIB.
Area of Science:
- Radiology
- Gastroenterology
- Emergency Medicine
Background:
- Acute gastrointestinal bleeding (GIB) is a frequent medical emergency.
- Computed tomography angiography (CTA) is a key diagnostic tool for GIB when endoscopy is negative.
- Limited data exists on predictors of positive CTA findings in GIB cases.
Purpose of the Study:
- To identify clinical and laboratory parameters predicting active GIB on CTA.
- To assess predictors of contrast material extravasation into the bowel lumen.
Main Methods:
- Single-center retrospective study of patients with GIB undergoing CTA.
- Comparison of patient characteristics between positive and negative CTA findings.
- Logistic regression analysis to identify predictive parameters for active GIB.
Main Results:
- 154 patients included; 16.2% had active GIB on CTA.
- Univariate analysis: CHF, warfarin use, high INR, and low albumin associated with active GIB.
- Multivariate analysis: High INR (OR 1.34) and low albumin (OR 0.3) remained significant predictors; high ASA score was negatively associated.
Conclusions:
- High INR and low albumin levels are strong predictors of active GIB on CTA.
- High ASA score did not correlate with a higher incidence of active GIB.
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