Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7500-7505
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7500
Patient characteristics with high or low blood urea nitrogen in upper gastrointestinal bleeding
Minoru Tomizawa, Fuminobu Shinozaki, Rumiko Hasegawa, Yoshinori Shirai, Yasufumi Motoyoshi, Takao Sugiyama, Shigenori Yamamoto, Naoki Ishige
Minoru Tomizawa, Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba 284-0003, Japan
Fuminobu Shinozaki, Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Rumiko Hasegawa, Yoshinori Shirai, Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Yasufumi Motoyoshi, Department of Neurology, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Takao Sugiyama, Department of Rheumatology, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Shigenori Yamamoto, Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Naoki Ishige, Department of Neurosurgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido City, Chiba 284-0003, Japan
Author contributions: Tomizawa M, Shinozaki F, Hasegawa R, and Shirai Y performed upper endoscopies; Motoyoshi Y, Sugiyama T, and Yamamoto S analyzed the data; Tomizawa M and Shinozaki F wrote the manuscript; and Ishige N supervised the investigation.
Ethics approval: The study was reviewed and approved by the National Hospital Organization Shimoshizu Hospital Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare no conflicts of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Minoru Tomizawa, MD, PhD, Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba 284-0003, Japan. nihminor-cib@umin.ac.jp
Telephone: +81-43-4222511 Fax: +81-43-4213007
Received: December 7, 2014
Peer-review started: December 8, 2014
First decision: January 22, 2015
Revised: February 2, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: June 28, 2015
Processing time: 204 Days and 2.3 Hours
Abstract

AIM: To examine characteristics of patients with blood urea nitrogen (BUN) levels higher and lower than the normal limit.

METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively. During this time, 3296 patients underwent upper endoscopy. In total, 50 male (69.2 ± 13.2 years) and 26 female (72.3 ± 10.2 years) patients were assessed. Patients were divided into two groups based on BUN levels: higher than the normal limit (21.0 mg/dL) (H) and lower than the normal limit (L). One-way analysis of variance was performed to reveal differences in the variables between the H and L groups. Fisher’s exact test was used to compare the percentage of patients with gastric ulcer or gastric cancer in the H and L groups.

RESULTS: White blood cell count was higher in the H group than in the L group (P = 0.0047). Hemoglobin level was lower in the H group than in the L group (P = 0.0307). Glycated hemoglobin was higher in the H group than in the L group (P = 0.0264). The percentage of patients with gastric ulcer was higher in the H group (P = 0.0002). The H group contained no patients with gastric cancer.

CONCLUSION: Patients with BUN ≥ 21 mg/dL might have more severe upper gastrointestinal bleeding.

Keywords: Blood urea nitrogen; Forrest classification; Hemoglobin; White blood cell count

Core tip: Blood urea nitrogen (BUN) is a useful predictor of upper gastrointestinal (GI) bleeding. However, BUN is within the normal range in some patients with upper GI bleeding. Patient records were analyzed retrospectively. Patients were divided into two groups: higher than the normal limit (21.0 mg/dL) (H) and lower than the normal limit (L). White blood cell count was higher and hemoglobin was lower in the H group. Higher BUN was associated with severe upper GI bleeding. The H group suggested more severe upper GI bleeding.