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Upper GI Bleed: Likelihood Ratios

Introduction: None written.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Gastrointestinal Problem Tag this Diagnosis.

The likelihood ratios of findings for Upper GI Bleed are listed below. See the left navigation bar to change the display.

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Finding +LR-LR Comments, Study
Angiography Edit inf0.4

sensitivity 63-90%

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

CT angiography Edit 5.90.1

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

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

Elevated BUN to Creatinine Ratio Edit 340.3

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

Hematochezia Edit 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

History of Ulcer Edit Sensitivity = 40%

specificity not assessed

Study: Gastrointest Endosc. 1995 Nov;42(5):390-7. PMID 8566625

Melena Edit 3.90.4

(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

Nasogastric Lavage Edit 4.70.6

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

Upper Endoscopy Edit 1.30.3

specificity ranges from 30-100%

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