Mo1092 C-Reactive Protein as a Predictive Marker for Rebleeding in the Patients With Acute Non-Variceal Upper Gastrointestinal Bleeding

Abstract

Background and Aims: Acute non-variceal upper GI bleeding (NUGIB) is an important clinical issue with high mortality rate. Rebleeding occurs in 10% to 25% of acute NUGIB patients irrespective of the treatment methods. Identification of patients at high risk of rebleeding is important to decide the appropriate treatment plan. C-reactive protein (CRP) has been reported as a prognostic indicator in various disorders. We were to investigate whether the initial CRP level can provide prognostic information for the risk of rebleeding in acute NUGIB patients. Patients and Methods: Between May 2011 and August 2013, 453 patients with acute NUGIB were investigated. The initial CRP level in the whole blood was evaluated in all patients. Rebleeding was checked for 30days after initial treatment. The clinical characteristics, endoscopic features, and CRP level were compared between the patients with and without rebleeding. Dichotomization of CRP level was performed with receiver operating characteristic (ROC) curve for the rebleeding. Results: The incidence of 30-day rebleeding was 15,9% (n = 72). The ROC curve area of CRP level in rebleeding was 0.69 (95% confidence interval, 0.618-0.760; p<0.001). Univariate analysis showed that old age (≥60 years), underlying comorbidities, hematochezia, shock (systolic blood pressure <100 mmHg), low hemoglobin level (<10 g/dL), high CRP level (≥0.5 mg/dL) and the presence of blood in the stomach were associated with the high risk of rebleeding. Multivariate logistic regression analysis indicated that initial CRP level of ≥0.5 mg/dL (p<0.01; OR, 3.6) was an independent factor for rebleeding after adjusting for initial hemoglobin level, shock, and the presence of blood in the stomach. Conclusions: CRP can be a useful predictive indicator for the risk of rebleeding in the patients with acute NUGIB.