Blood urea nitrogen and endoscopic pattern relationship in patients with gastrointestinal bleeding

Introduction

Blood urea nitrogen (BUN) increased in active upper gastrointestinal bleeding. The relationship between BUN and endoscopic pattern is not fully investigated.

Patients and methods

From January 2001 to October 2004, 157 (male/female, 123/34; mean age 69.3 years) were admitted to our hospital because of signs of gastrointestinal bleeding (hemathe-mesis and/or melaena). At admission to the Emergency Department, haemodynamics parameters (cardiac rate, arterial pressure) and laboratory blood tests (complete blood count, creatinine, electrolyte, BUN, albumin) were measured. All patients underwent endoscopy within 8 hours and Forrest's criteria for gastrointestinal bleeding were used: F1, active bleeding; F2, signs of recent bleeding (clot); F3, healing ulcer. During hospitalization, the history, past treatment, haemotransfusion, rebleeding and surgical treatment were also recorded. Data were analyzed in a statistical manner and t tests for unpaired data and univariate analysis were performed.

Results

Among 157 upper gastrointestinal bleeding cases, 128 were peptic ulcer and classified, according to Forrest's criteria, as: 23 F1, 61 F2 and 44 F3. Bleeding recurrence occurred in 10/128 (7.7%); no patients underwent surgery. There was a significant difference between the three groups for: number of blood units transfused, BUN, BUN/creatinine ratio, systolic blood pressure, and length of hospital stay (P < 0.05) (see also Table 1).

Table 1 (abstract P224)

Conclusion

BUN levels and the BUN/creatinine ratio correlate with Forrest's different ulcer patterns. These could identify patients who need an early endoscopic evaluation and more intensive treatment.