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Predictive factors of upper gastrointestinal bleeding in children: a cross-sectional analysis
Mehrnush Shams1, Sanaz Mehrabani2, Mohammad Reza Esmaili Dooki1
1Department of Pediatrics, Faculty of Medicine, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Mazandaran, Iran.
Insights
Prolapse gastropathy is the main cause of upper gastrointestinal bleeding in children. Male gender, abdominal pain, and platelet count help predict risk for better management.
Area of Science:
- Pediatric Gastroenterology
- Clinical Diagnostics
- Medical Research
Background:
- Upper gastrointestinal bleeding (UGIB) in children poses diagnostic challenges.
- Etiology and prolapse gastropathy in pediatric UGIB require further characterization.
Purpose of the Study:
- Identify endoscopic findings and clinical predictors of pediatric UGIB.
- Emphasize prolapse gastropathy as a distinct entity.
- Develop a predictive model for risk stratification of pediatric UGIB.
Main Methods:
- Cross-sectional study of 100 children (2 months–17 years) with UGIB.
- Collected demographic, clinical, laboratory, and endoscopic data.
- Employed univariate and multivariate logistic regression to identify predictors.
Main Results:
- Prolapse gastropathy was the leading pathological finding (27%) in pediatric UGIB.
- Male gender predicted prolapse gastropathy (OR=3.87); NSAID use predicted peptic ulcer (OR=127.3).
- Abdominal pain (OR=111.6) and platelet count were independent predictors, achieving 97.0% model accuracy.
Conclusions:
- Prolapse gastropathy is the predominant cause of UGIB in children.
- Male gender, abdominal pain, and platelet count are significant predictors.
- These predictors enable evidence-based risk stratification for pediatric UGIB.
Background:
Upper gastrointestinal bleeding (UGIB) in children presents diagnostic challenges. Geographic variations in etiology and the role of prolapse gastropathy as a distinct entity remain poorly characterized.
Objectives:
To identify endoscopic findings and clinical predictors of pediatric UGIB, with an emphasis on prolapse gastropathy, and to develop a predictive model for risk stratification.
Methods:
This cross-sectional study enrolled 100 children (aged 2 months to 17 years) with UGIB. Demographic, clinical, laboratory, and endoscopic data were collected. Univariate and multivariate logistic regression identified predictors.
Results:
The mean age of the children was 7.2 ± 4.1 years; 62% presented with hematemesis. In 41% of cases, the endoscopic findings were normal; prolapse gastropathy was the leading pathological finding (27%). Male gender was associated with prolapse gastropathy (OR = 3.87, p = 0.007); NSAID use predicted peptic ulcer (OR = 127.3, p < 0.001). Multivariate analysis identified abdominal pain (OR = 111.6, p < 0.001) and platelet count (p = 0.006) as independent predictors, with 97.0% model accuracy.
Conclusion:
Prolapse gastropathy represents the predominant pathological cause of UGIB in children. Male gender, abdominal pain, and platelet count are significant predictors enabling evidence-based risk stratification.
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