Electrodermal Screening of Biologically Active Points for Upper Gastrointestinal Bleeding

2014 ◽  
Vol 42 (05) ◽  
pp. 1111-1121 ◽  
Author(s):  
Ying-Jung Tseng ◽  
Wen-Long Hu ◽  
I-Ling Hung ◽  
Chia-Jung Hsieh ◽  
Yu-Chiang Hung
Keyword(s):  
Logistic Regression ◽  
Small Intestine ◽  
Gastrointestinal Bleeding ◽  
Roc Curve ◽  
Electrical Resistance ◽  
Upper Gastrointestinal Bleeding ◽  
Biologically Active ◽  
Specific Information ◽  
Upper Gastrointestinal ◽  
Biologically Active Points

The purpose of this case-control study was to investigate the relationship between the electrical resistance of the skin at biologically active points (BAPs) on the main meridians and upper gastrointestinal bleeding (UGIB). Electrical resistance to direct current at 20 BAPs on the fingers and toes of 100 patients with (38 men, 12 women; mean age [range], 58.20 ± 19.62 [18–83] years) and without (27 men, 23 women; 49.54 ± 12.12 [22–74] years) UGIB was measured through electrodermal screening (EDS), based on the theory of electroacupuncture according to Voll (EAV). Data were compared through analysis of variance (ANOVA), receiver operating characteristic (ROC) curve analysis, and logistic regression. The initial readings were lower in the UGIB group, indicating blood and energy deficiency due to UGIB. Significant differences in indicator drop values were observed at nine BAPs (p < 0.05) on the bilateral small intestine, bilateral stomach, bilateral circulation, bilateral fibroid degeneration, and right lymph meridians. The area under the ROC curve values of the BAPs on the bilateral small intestine and stomach meridians were larger than 0.5, suggesting the diagnostic accuracy of EDS for UGIB on the basis of the indicator drop of these BAPs. Logistic regression revealed that when the indicator drop of the BAP on the left stomach meridian increased by one score, the risk of UGIB increased by about 1.545–3.523 times. In conclusion, the change in the electrical resistance of the skin measured by EDS at the BAPs on the bilateral small intestine and stomach meridians provides specific information on UGIB.

scholarly journals Predictive Role of Admission Venous Lactate Level in Patients with Upper Gastrointestinal Bleeding: A Prospective Observational Study

2022 ◽  
Vol 11 (2) ◽  
pp. 335
Author(s):  
Marcin Strzałka ◽  
Marek Winiarski ◽  
Marcin Dembiński ◽  
Michał Pędziwiatr ◽  
Andrzej Matyja ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Roc Curve ◽  
Lactate Level ◽  
Surgical Intervention ◽  
Upper Gastrointestinal Bleeding ◽  
Lactate Levels ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding (UGIB) is one of the most common emergencies. Risk stratification is essential in patients with this potentially life-threatening condition. The aim of this prospective study was to evaluate the usefulness of the admission venous lactate level in predicting clinical outcomes in patients with UGIB. All consecutive adult patients hospitalized due to UGIB were included in the study. The clinical data included the demographic characteristics of the observed population, etiology of UGIB, need for surgical intervention and intensive care, bleeding recurrence, and mortality rates. Venous lactate was measured in all patients on admission. Logistic regression analyses were used to calculate the odds ratios (OR) of lactate levels for all outcomes. The receiver operating characteristic (ROC) curve was used to determine the accuracy of lactate levels in measuring clinical outcomes, while Youden index was used to calculate the best cut-off points. A total of 221 patients were included in the study (151M; 70F). There were 24 cases of UGIB recurrence (10.8%), 19 patients (8.6%) required surgery, and 37 individuals (16.7%) required intensive care. Mortality rate was 11.3% (25 cases). The logistic regression analysis showed statistically significant association between admission venous lactate and all clinical outcomes: mortality (OR = 1.39, 95%CI: 1.22–1.58, p < 0.001), recurrence of bleeding (OR = 1.16, 95%CI: 1.06; 1.28, p = 0.002), surgical intervention (OR = 1.17, 95%CI: 1.06–1.3, p = 0.002) and intensive care (OR = 1.33, 95%CI: 1.19–1.5, p < 0.001). The ROC curve analysis showed a high predictive value of lactate levels for all outcomes, especially mortality: cut-off point 4.3 (AUC = 0.82, 95%CI: 0.72–0.92, p < 0.001) and intensive care: cut-off point 4.2 (AUC = 0.76, 95%CI: 0.66–0.85, p < 0.001). Admission venous lactate level may be a useful predictive factor of clinical outcomes in patients with UGIB.

Jejunal Perforation as a Result of Massive Gastrointestinal Bleeding from a Duodenal Ulcer

1984 ◽  
Vol 29 (2) ◽  
pp. 109-110
Author(s):  
J. N. Fox ◽  
J. W. W. Thomson
Keyword(s):  
Duodenal Ulcer ◽  
Small Intestine ◽  
Case Report ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Massive Bleeding ◽  
Spontaneous Perforation ◽  
Massive Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

A complication of massive upper gastrointestinal bleeding is presented as a case report of a patient who developed a spontaneous perforation of the small intestine as a result of massive bleeding from a duodenal ulcer

scholarly journals Risk Factors for Acute Coronary Syndrome in Upper Gastrointestinal Bleeding Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Tianyu Chi ◽  
Quchuan Zhao ◽  
Peili Wang
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Heart Disease ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Coronary Syndrome ◽  
Upper Gastrointestinal

Background. Upper gastrointestinal bleeding (UGIB) is a common critical disease with a certain fatality rate. Acute coronary syndrome (ACS), another critical ill condition, is a regular occurrence in the UGIB. We identified risk factors for ACS in UGIB. Methods. 676 patients diagnosed with UGIB were enrolled retrospectively. We assessed the occurrence of ACS in UGIB patients and identified the risk factors for ACS by logistic regression analysis and random forest analysis. Results. After propensity score matching (PSM), the ACS group ( n = 69 ) and non-ACS group ( n = 276 ) were analyzed. Logistic regression analysis showed that syncope ( P = 0.001 ), coronary heart disease history ( P = 0.001 ), Glasgow Blatchford score ( P ≤ 0.001 ), Rockall risk score ( P = 0.004 ), red blood cell distribution width (RDW) ( P ≤ 0.001 ), total bilirubin (TBil) ( P = 0.046 ), fibrinogen ( P ≤ 0.001 ), and hemoglobin ( P = 0.001 ) had important roles in ACS patients. With Mean Decrease Gini (MDG) sequencing, fibrinogen, RDW, and hemoglobin were ranked the top three risk factors associated with ACS. In ROC analysis, fibrinogen ( AUC = 0.841 , 95% CI: 0.779-0.903) and RDW ( AUC = 0.826 , 95% CI: 0.769-0.883) obtained good discrimination performance. According to sensitivity > 80 %, the pAUC of fibrinogen and RDW were 0.077 and 0.101, respectively, and there was no significant difference ( P = 0.326 ). However, according to specificity > 80 %, the pAUC of fibrinogen was higher than that of RDW (0.126 vs. 0.088, P = 0.018 ). Conclusion. Fibrinogen and RDW were important risk factors for ACS in UGIB. Additionally, combination with coronary heart disease, syncope, hemoglobin, and TBil played important roles in the occurrence of ACS. Meanwhile, it was also noted that Rockall score and Glasgow Blatchford score should be performed to predict the risk.

scholarly journals Validation of a New Risk Score System for Non-variceal Upper Gastrointestinal Bleeding

2020 ◽  
Author(s):  
Min Seong Kim ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Jae Ho Park ◽  
Ju Seok Kim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Gastrointestinal Bleeding ◽  
Hospital Stay ◽  
Roc Curve ◽  
Scoring System ◽  
Operating Characteristic ◽  
Upper Gastrointestinal Bleeding ◽  
Bleeding Score ◽  
Upper Gastrointestinal ◽  
New Scoring

Abstract Background: Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure.Methods: A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.Results: The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806-0.856; P<0.001), PNED (AUROC, 0.865; 95%CI, 0.841-0.886; P<0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774-0.827; P<0.001), and GBS (AUROC, 0.765; 95%CI, 0.736-0.793; P <0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 hours during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed.Conclusion: The new international bleeding score could predict 30-day mortality better than the other scoring systems. High-risk patients can be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seems to improve the outcomes of non-variceal UGIB patients through proper management and intervention.

scholarly journals Validation of a New Risk Score System for Non-variceal Upper Gastrointestinal Bleeding

2019 ◽  
Author(s):  
Min Seong Kim ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Jae Ho Park ◽  
Ju Seok Kim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Gastrointestinal Bleeding ◽  
Roc Curve ◽  
Scoring System ◽  
Operating Characteristic ◽  
Upper Gastrointestinal Bleeding ◽  
Scoring Systems ◽  
Bleeding Score ◽  
Upper Gastrointestinal ◽  
New Scoring

Abstract Background Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay and endoscopic failure.Methods A retrospective study was performed on 905 cases with acute non-varieal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.Results Compared with other scoring systems, the new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality. (area under ROC curve 0.832; [95% confidence interval (CI)]) Multivariate analysis was performed using our data, the 30-day mortality rate was related to multiple comorbidities, BUN, creatinine, albumin, syncope at first visit, and endoscopic failure at first admission within 24 hours. In addition, in the new high score group, relatively long hospital stays, re-bleeding, and endoscopic failure were observed.Conclusion The new international bleeding score could predict 30-day mortality better than the other scoring systems. High-risk patients can be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seems to improve the outcomes of non-variceal UGIB patients through proper management and intervention.

scholarly journals Prediction of esophageal varices and variceal hemorrhage in patients with acute upper gastrointestinal bleeding

2016 ◽  
Vol 64 (3) ◽  
pp. 745-751 ◽  
Author(s):  
Don C Rockey ◽  
Alan Elliott ◽  
Thomas Lyles
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Gastrointestinal Bleeding ◽  
Esophageal Varices ◽  
Upper Gastrointestinal Bleeding ◽  
Area Under The Curve ◽  
Variceal Hemorrhage ◽  
Esophageal Variceal ◽  
Non Invasive ◽  
Upper Gastrointestinal

In patients with upper gastrointestinal bleeding (UGIB), identifying those with esophageal variceal hemorrhage prior to endoscopy would be clinically useful. This retrospective study of a large cohort of patients with UGIB used logistic regression analyses to evaluate the platelet count, aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase (ALT) ratio (AAR) and Lok index (all non-invasive blood markers) as predictors of variceal bleeding in (1) all patients with UGIB and (2) patients with cirrhosis and UGIB. 2233 patients admitted for UGIB were identified; 1034 patients had cirrhosis (46%) and of these, 555 patients (54%) had acute UGIB due to esophageal varices. In all patients with UGIB, the platelet count (cut-off 122,000/mm3), APRI (cut-off 5.1), AAR (cut-off 2.8) and Lok index (cut-off 0.9) had area under the curve (AUC)s of 0.80 0.82, 0.64, and 0.80, respectively, for predicting the presence of varices prior to endoscopy. To predict varices as the culprit of bleeding, the platelet count (cut-off 69,000), APRI (cut-off 2.6), AAR (cut-off 2.5) and Lok Index (0.90) had AUCs of 0.76, 0.77, 0.57 and 0.73, respectively. Finally, in patients with cirrhosis and UGIB, logistic regression was unable to identify optimal cut-off values useful for predicting varices as the culprit bleeding lesion for any of the non-invasive markers studied. For all patients with UGIB, non-invasive markers appear to differentiate patients with varices from those without varices and to identify those with a variceal culprit lesion. However, these markers could not distinguish between a variceal culprit and other lesions in patients with cirrhosis.

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