Background
Adequate visibility is an important factor for achieving successful endoscopic hemostasis
for the treatment of upper GI bleeding (UGIB). The independent factors that affect
visibility during endoscopic procedures have yet to be determined.
Objective
To determine the factors that affect endoscopic visibility and to create a model that
can predict in which patients unacceptable visibility is suspected before emergent
endoscopic procedures for UGIB.
Design
Prospective, observational study.
Setting
University-affiliated tertiary care hospital in South Korea.
Patients
A total of 121 patients admitted because of UGIB.
Intervention
Analysis of the visibility score of the emergency endoscopies for UGIB.
Main Outcome Measurements
Factors affecting the visibility score of endoscopy and a classification and regression
tree (CART) model for predicting of visibility.
Results
The EGD time and the appearance of the nasogastric (NG) tube aspirate were independent
factors that were significantly associated with visibility (EGD time, P < .001; red blood appearance in NG tube aspirate, P < .001; coffee grounds appearance of NG tube aspirate, P = .006). Based on these results, a CART model was developed by using 70 patients
who had been allocated to the training set. The CART generated algorithms that proposed
the use of the appearance of the NG tube aspirate and the EGD time (8.5 hours) to
predict visibility. The sensitivity and specificity for predicting poor visibility
were 71.4% and 86.4%, respectively.
Conclusion
The use of the CART model enables the prediction of which patients will have poor
visibility during emergent endoscopy.
Abbreviations:
CART (classification and regression tree), NG (nasogastric), UGIB (upper GI bleeding)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 12, 2015
Accepted:
December 1,
2014
Received:
September 19,
2014
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
If you would like to chat with an author of this article, you may contact Dr Park at [email protected]
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
