Volume 10 Supplement 1

26th International Symposium on Intensive Care and Emergency Medicine

Open Access

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

  • A Graziani1,
  • G Nicolini1,
  • M Chiesa1,
  • F Morgagni1,
  • G Milandri1,
  • S Bonarelli1 and
  • A Fanciulli1
Critical Care200610(Suppl 1):P224

https://doi.org/10.1186/cc4571

Published: 21 March 2006

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)

 

Forrest 1 (23 patients)

Forrest 2 (61 patients)

Forrest 3 (44 patients)

Hct (%)

26.9 ± 7.2

28.7 ± 7.3

28.2 ± 7.0

WBC (mmc)

11,217 ± 4884

11,944 ± 4573

10,381 ± 4749

PLT (mmc)

243,147 ± 79,587

252,923 ± 84,948

225,590 ± 86,796*

Creatinine (mg/dl)

1.6 ± 1.0*

1.1 ± 0.4

1.2 ± 0.5

BUN (mg/dl)

53.1 ± 16.6*

45 ± 15.3

40 ± 10.9

BUN/creatinine

39.9 ± 14.1*

39.4 ± 14.2*

34.6 ± 11.2

Na (mEq/l)

139.8 ± 5.7

138.7 ± 3.5

139.7 ± 4.1

DBP

72.6 ± 14.8

70.1 ± 13.0

75.8 ± 12.9

SBP

125.4 ± 31.1

117.7 ± 21.1*

133.0 ± 25.5

Heart rate (bpm)

93.9 ± 20.8

95.1 ± 19.1

90.0 ± 13.7

Number of blood transfusions

3.8 ± 2.9*

3.2 ± 2.7

2.1 ± 1.9

Hospital stay (days)

12.0 ± 6.7*

7.1 ± 4.8

8.6 ± 8.1

*P < 0.05. DBP, diastolic blood pressure; SBP, systolic blood pressure.

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.

Authors’ Affiliations

(1)
Ospedale M. Bufalini

Copyright

© BioMed Central Ltd 2006

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