Upper GI Bleed: Sensitivity and Specificity

Introduction: None written.

The sensitivity and specificity of findings for Upper GI Bleed are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

89%

85%

sensitivity reported in animal models to be .3 ml/min

Study: World J Gastroenterol. 2010 Aug 21;16(31):3957-63. PMID: 20712058

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Angiography	63%	100%	sensitivity 63-90% Study: Radiographics. 2007 Jul-Aug;27(4):1055-70. PMID: 17620467
Elevated BUN to Creatinine Ratio	68%	98%	In a PEDIATRIC pt with either an upper or lower GI bleed, when the BUN to Creatinine ratio was 30 or above, the specificity of upper GI bleeding vs. lower GI bleeding was 98% with a sensitivity of 68.8% Study: PMID: 1403455
Nasogastric Lavage	42%	91%	in patients without hematemesis Note that in principle if there is no bile, bleeding distal to the pylorus cannot be excluded. Study: Ann Emerg Med. 2004 Apr;43(4):525-32. PMID 15039700

Sensitive Findings

92%

30%

specificity ranges from 30-100%

Study: Radiographics. 2007 Jul-Aug;27(4):1055-70. PMID: 17620467

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Melena	71%	82%	(for specificity, i.e. 18% of lower GI bleed have melena) Study: Emerg Med Clin North Am. 1999 Feb;17(1):239-61, x. PMID 10101349
History of Ulcer	Sensitivity = 40%		specificity not assessed Study: Gastrointest Endosc. 1995 Nov;42(5):390-7. PMID 8566625
Hematochezia	Sensitivity = 14%		i.e. bright red blood in stool specificity not assessed. Study: Emerg Med Clin North Am. 1999 Feb;17(1):239-61, x. PMID 10101349