| Title |
Presence of Melena in Obscure Gastrointestinal Bleeding Predicts Bleeding in the Proximal Small Intestine
|
|---|---|
| Published in |
Digestive Diseases and Sciences, March 2018
|
| DOI | 10.1007/s10620-018-5003-x |
| Pubmed ID | |
| Authors |
Cindy Ningfu Zhu, Joshua Friedland, Brian Yan, Aze Wilson, Jamie Gregor, Vipul Jairath, Michael Sey |
| Abstract |
Melena is a symptom of upper gastrointestinal bleeding and usually indicates bleeding proximal to the ligament of Treitz. However, whether melena predicts bleeding in the proximal small intestine in patients with obscure gastrointestinal bleeding (OGIB) is unknown and the objective of this study. A retrospective cohort study of consecutive patients undergoing capsule endoscopy for OGIB between July 2009 and May 2016 was conducted. Subjects were categorized based on the presence of melena, and the primary outcome was identification of a bleeding source within the proximal 2/3 of the small intestine. Multi-variable regression was performed to control for confounders. During the study, 288 patients met the eligibility criteria. Subjects with melena accounted for 37.1% of the cohort and were more likely to be older (mean age 66.9 vs. 63.9, p = 0.0457), take warfarin (15.1 vs. 9.4%, p = 0.0122), and have a lower 12-month hemoglobin nadir (7.3 vs. 8.3 g/dL, p = 0.0002). On crude analysis, 56.1% of patients with melena had a bleeding source within the proximal small intestine compared to 34.8% for those without (RR 1.61, 95% CI 1.24-2.09, p = 0.0004). On multi-variable analysis, the presence of melena doubled the odds of finding a bleeding site within the proximal small intestine (OR 1.97, 95% CI 1.17-3.33, p = 0.010). The presence of melena doubles the odds of finding a bleeding site within the proximal small intestine among patients with OGIB, and deep enteroscopy, if performed before a capsule study, should begin with an antegrade approach in these patients. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 10 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 10 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Unspecified | 1 | 10% |
| Lecturer > Senior Lecturer | 1 | 10% |
| Other | 1 | 10% |
| Student > Doctoral Student | 1 | 10% |
| Student > Master | 1 | 10% |
| Other | 2 | 20% |
| Unknown | 3 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 4 | 40% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 10% |
| Unspecified | 1 | 10% |
| Unknown | 4 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 April 2018.
All research outputs
#15,498,675
of 23,854,458 outputs
Outputs from Digestive Diseases and Sciences
#2,787
of 4,304 outputs
Outputs of similar age
#202,924
of 335,588 outputs
Outputs of similar age from Digestive Diseases and Sciences
#44
of 85 outputs
Altmetric has tracked 23,854,458 research outputs across all sources so far. This one is in the 34th percentile – i.e., 34% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,304 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one is in the 34th percentile – i.e., 34% of its peers scored the same or lower than it.
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We're also able to compare this research output to 85 others from the same source and published within six weeks on either side of this one. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.