Are the blood urea nitrogen/creatinine ratio and the mean platelet volume able to act as predictors of mortality and morbidity in patients with upper gastrointestinal bleeding?

Abstract

Background: Upper gastrointestinal (GI) bleeding originates above the Treitz ligament and blood urea nitrogen (BUN)/Creatinine (Cr) ratio ≥30 was shown to indicate the presence of upper GI bleeding and it might be an independent risk factor for mortality. The mean platelet volume (MPV) was reported as an indicator of platelet function and activation and was shown to be useful in the diagnosis and follow-up of vascular-origin disorders. In the present study, we aimed to investigate whether BUN/Cr ratio and MPV were predictors of mortality and morbidity in patients with upper GI bleeding. Material and Method: This retrospective study enrolled a total of 141 patients admitted to the Emergency Department with symptoms of upper GI bleeding and had undergone endoscopy between January 2013-January 2015. Demographics, hemoglobin, hematocrit, MPV, BUN/Cr, the hospitalization unit, the duration of stay, outcome, and the endoscopy reports of the patients were recorded. Statistical analysis was performed using SPSS 17.0. Results:  It was found that the MPV level did not predict mortality and morbidity in our patients with upper GI bleeding. The likelihood of active bleeding was higher in patients with a BUN/Cr ratio of above 30 when compared to those with a ratio of below 30. Conclusion: In patients presenting to the emergency department with symptoms of GI bleeding but without signs of renal failure, calculation of admission BUN/Cr ratio may be beneficial for making treatment and follow-up plans.

Keywords

• upper gastrointestinal bleeding
• blood urea nitrogen/creatinine ratio
• mean platelet volume
• morbidity
• mortality

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