The Clinical Value Of Red Blood Cell Distribution Width In Acute Non-varicose Upper Gastrointestinal Bleeding

Objective To evaluate the clinical value of red blood cell distribution width(RDW)as a serological marker for acute non-varicose upper gastrointestinal bleeding(ANVUGIB).Methods Retrospective study was conducted to study the clinical data and correlation scores of ANVUGIB patients who visited the General Hospital of Ningxia Medical University from May 2015 to May 2018 and were first diagnosed as ANVUGIB after digestive endoscopy or discharge.High-risk ANVUGIB patients were determined according to the internationally recognized Rockall scoring system(?5 points),and all patients were divided into the high RDW group(?13.8%)and the low RDW group(<13.8%),to analyze the role of RDW in the condition assessment of ANVUGIB patients.ROC curves were used to compare the predictive power of RDW,RDW and other scoring systems for high-risk bleeding patients.Results In the end,739 ANVUGIB patients met the inclusion criteria,including 608 males and 131 females,aged 18-91 years,with an average age of(53.25 ± 17.5)years.According to the Rockall score,low-risk patients(5.4%,n = 40),intermediate-risk patients(40.6%,n = 300),and high-risk patients(54.0%,n = 399).The three groups were based on age,gender,previous useful drug history,and The history of peptic ulcer,whether there were comorbidities,syncope,hemoglobin,RDW,urea value,albumin,neutrophil count,blood transfusion,endoscopic treatment and scoring system were significantly different(P <0.05),and Pairwise comparison between groups,the difference between the high-risk group and the low-risk group was statistically significant(P <0.05),and the pairwise comparison between the groups,the difference between the high-risk group and the intermediate-risk group,theintermediate-risk group and the low-risk group,and the high-risk group and the low-risk group were statistically significant(P <0.05).Secondly,according to the median RDW of13.8%,the high RDW group(64.6%,n = 478)and the low RDW group(35.4%,n = 261)were divided into two groups.The data of the two groups were compared and analyzed.Complications,pulse rate> 100 / min,presence or absence of syncope,hemoglobin value,albumin,number of high-risk groups,number of deaths at 6 months,and scoring system were statistically significant(P <0.05).At the same time,after performing a single factor analysis and adjusting related influencing factors,multivariate logistic regression analysis still showed that RDW?13.8 was still an independent risk factor for high-risk ANVUGIB patients.Finally,it can be seen from statistics that the RDW value,GBS,and AIMS65 scores of the low-risk group,intermediate-risk group,and high-risk group gradually increased in order,and the differences in RDW value,GBS,and AIMS65 scores of the three groups of patients were statistically significant(P <0.05),RDW was positively correlated with GBS and AIMS65 scores.And we discuss the diagnostic efficacy of RDW in predicting high-risk ANVUGIB patients,when the critical value of RDW is 13.8%,the sensitivity is 68.9%,the specificity is60.6%,and the area under the curve is 0.731.When RDW and GBS jointly predict high-risk ANVUGIB patients,the area under the curve is 0.785,and the sensitivity is 73.4%,the specificity is 66.7%.When RDW and AIMS65 are jointly predicted high-risk ANVUGIB patients,the area under the curve is 0.744,the sensitivity is 61.2%,the specificity is 74.1%.Conclusion1.RDW can be used as a serological marker to assess the risk of ANVUGIB and is an independent risk factor for high-risk ANVUGIB patients.2.In ANVUGIB patients,the combination of RDW and other scoring indicators can appropriately improve the ability to differentiate risk stratification,which has predictive value for the risk of death in hospitalized patients.