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Factors that affect visibility during endoscopic hemostasis for upper GI bleeding: a prospective study

 Sungmo Jung  ;  Eun Hye Kim  ;  Ha Yan Kim  ;  Yun Ho Roh  ;  Chan Hyuk Park  ;  Soo Jung Park  ;  Hyunsoo Chung  ;  Beom Kyung Kim  ;  Hyuk Lee  ;  Jae Jun Park  ;  Sung Pil Hong  ;  Jun Yong Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Jun Chul Park 
 GASTROINTESTINAL ENDOSCOPY, Vol.81(6) : 1392-1400, 2015 
Journal Title
Issue Date
Adult ; Aged ; Algorithms ; Endoscopy, Gastrointestinal* ; Female ; Gastrointestinal Hemorrhage/diagnosis* ; Gastrointestinal Hemorrhage/therapy* ; Hemostasis, Endoscopic* ; Humans ; Male ; Middle Aged ; Prospective Studies ; Republic of Korea ; Young Adult
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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Eun Hye(김은혜) ORCID logo https://orcid.org/0000-0001-6691-6837
Kim, Ha Yan(김하얀)
Roh, Yun Ho(노윤호)
Park, Soo Jung(박수정)
Park, Jae Jun(박재준)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Chan Hyuk(박찬혁)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Jung, Sung Mo(정성모)
Chung, Hyun Soo(정현수)
Hong, Sung Pil(홍성필)
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