Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.121498
Revised: April 28, 2026
Accepted: May 9, 2026
Published online: July 27, 2026
Processing time: 119 Days and 0.1 Hours
Gastrointestinal bleeding (GIB) is common in children and may lead to anemia, yet the risk factors for anemia in pediatric GIB remain poorly understood.
To characterize hospitalized pediatric patients with GIB and to evaluate GIB in
Pediatric patients hospitalized with GIB between December 2022 and December 2025 at Anhui Provincial Children’s Hospital, were enrolled in this single center retrospective study. Demographic, clinical presentation, laboratory evaluation and final diagnosis were obtained. Based on the presence or absence of anemia, patients were classified into anemic group and non-anemic group. The intergroup comparisons were performed by the non-parametric test and the χ2 test. In
The study included 257 hospitalized children with GIB, 45 of whom showed anemia, the anemic group has older children than 5 year and greater proportion of rural children (P < 0.05). The anemic group has higher rate of melena and the non-anemic group has a higher percentage of children with hematochezia and diarrhea. The results of laboratory tests showed lower white blood cell count, monocyte count, lymphocyte count, albumin level, serum potassium level, as well as higher levels of blood urea nitrogen and prothrombin time, and a shorter activated partial thromboplastin time (APTT) in anemic group (P < 0.05). Multivariate Logistic regression analysis revealed that melena, low albumin levels, low lymphocyte counts, and shortened APTT were independent risk factors for anemia. On the other hand, diarrhea was an independent protective factor (P < 0.05). Additionally, the risk of anemia was significantly lower in children aged 2-5 years than in those aged ≤ 2 years (P < 0.05).
The incidence of anemia in hospitalized children with GIB was 17.5%, and it was closely related to age, clinical manifestations, and several laboratory indicators. Melena, low albumin, low lymphocyte count, and shortened APTT were closely associated with the occurrence of anemia. High-risk children should be identified and managed in a timely manner to reduce the incidence of anemia.
Core Tip: This single-center retrospective study of 257 hospitalized children found an anemia incidence of 17.5%. Key independent risk factors for anemia included melena, low albumin levels, low lymphocyte count, and shortened activated partial thromboplastin time (APTT). Diarrhea was identified as a protective factor. Notably, shortened APTT, rather than prolonged APTT, emerged as a novel independent risk factor, suggesting a possible compensatory coagulation response to chronic bleeding. These findings highlight the necessity of early identification of high-risk children to enable timely intervention.