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Prealbumin and D-dimer as Prognostic Indicators for Rebleeding in Patients with Nonvariceal Upper Gastrointestinal Bleeding

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Abstract

Background

Determining the risk stratification of nonvariceal upper gastrointestinal bleeding (NVUGIB) plays a vital role in treating upper gastrointestinal bleeding (UGIB). Traditional scores like Glasgow–Blatchford score (GBS), Rockall score (RS), and AIMS65 score have been widely utilized in UGIB practice, however exhibiting limited practical use due to relative lack of user-friendly characters. Prealbumin as a nutritional indicator and d-dimer as a fibrinolytic activity monitor, are generally used to evaluate the overall nutritional and fibrinolytic condition in UGIB patients.

Aims

Here, we explored the predictive value of these two markers in NVUGIB for evaluating severity and prognosis including rebleeding and surgery intervention.

Methods

One hundred and eighty-five patients suffering NVUGIB were enrolled. Their GBS, RS, and AIMS65 score, routine laboratory test results including prealbumin and d-dimer were determined after admission. Multivariate regression analysis was performed to define the independent predictors of rebleeding. ROC curves were generated to compare the suitability of prealbumin, d-dimer, and scores for rebleeding prediction.

Results

The NVUGIB patients with rebleeding exhibited higher scores, white blood cell counts, d-dimer, CRP, proportion of surgery intervention, and longer hospital stay, but lower hematocrit, hemoglobin, calcium, prealbumin, and fibrinogen than those without rebleeding. The multivariate regression analysis demonstrated that prealbumin and d-dimer were independent predictors for rebleeding. Values of prealbumin and d-dimer were correlated with hospital stay, ulcer degrees, and surgery demand. The ROC curve analyses showed that prealbumin and d-dimer exhibited superior prediction value over the scoring systems.

Conclusions

Prealbumin and d-dimer are promising predictors for severity and prognosis in NVUGIB practice.

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Acknowledgments

This work was supported by Grants from the National Natural Science Foundation of China (No. 81630016, to Jie Liu).

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Authors and Affiliations

  1. Department of Digestive Diseases, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Shanghai, 200040, People’s Republic of China

    Wenjie Yue, Yi Liu, Weiru Jiang, Jianping Huang & Jie Liu

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  1. Wenjie Yue
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  2. Yi Liu
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Correspondence to Yi Liu.

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Yue, W., Liu, Y., Jiang, W. et al. Prealbumin and D-dimer as Prognostic Indicators for Rebleeding in Patients with Nonvariceal Upper Gastrointestinal Bleeding. Dig Dis Sci 66, 1949–1956 (2021). https://doi.org/10.1007/s10620-020-06420-1

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  • DOI: https://doi.org/10.1007/s10620-020-06420-1

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