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Background <p>Upper gastrointestinal bleeding (UGIB) in children presents diagnostic challenges. Geographic variations in etiology and the role of prolapse gastropathy as a&#xa0;distinct entity remain poorly characterized.</p> Objectives <p>To identify endoscopic findings and clinical predictors of pediatric UGIB, with an emphasis on prolapse gastropathy, and to develop a&#xa0;predictive model for risk stratification.</p> Methods <p>This cross-sectional study enrolled 100 children (aged 2&#xa0;months to 17&#xa0;years) with UGIB. Demographic, clinical, laboratory, and endoscopic data were collected. Univariate and multivariate logistic regression identified predictors.</p> Results <p>The mean age of the children was 7.2 ± 4.1&#xa0;years; 62% presented with hematemesis. In 41% of cases, the endoscopic findings were normal; prolapse gastropathy was the leading pathological finding (27%). Male gender was associated with prolapse gastropathy (OR = 3.87, <i>p</i> = 0.007); NSAID use predicted peptic ulcer (OR = 127.3, <i>p</i> &lt; 0.001). Multivariate analysis identified abdominal pain (OR = 111.6, <i>p</i> &lt; 0.001) and platelet count (<i>p</i> = 0.006) as independent predictors, with 97.0% model accuracy.</p> Conclusion <p>Prolapse gastropathy represents the predominant pathological cause of UGIB in children. Male gender, abdominal pain, and platelet count are significant predictors enabling evidence-based risk stratification.</p>

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Predictive factors of upper gastrointestinal bleeding in children: a cross-sectional analysis

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Mehrnush Shams,
  • Sanaz Mehrabani,
  • Mohammad Reza Esmaili Dooki,
  • Soraya Khafri

摘要

Background

Upper gastrointestinal bleeding (UGIB) in children presents diagnostic challenges. Geographic variations in etiology and the role of prolapse gastropathy as a distinct entity remain poorly characterized.

Objectives

To identify endoscopic findings and clinical predictors of pediatric UGIB, with an emphasis on prolapse gastropathy, and to develop a predictive model for risk stratification.

Methods

This cross-sectional study enrolled 100 children (aged 2 months to 17 years) with UGIB. Demographic, clinical, laboratory, and endoscopic data were collected. Univariate and multivariate logistic regression identified predictors.

Results

The mean age of the children was 7.2 ± 4.1 years; 62% presented with hematemesis. In 41% of cases, the endoscopic findings were normal; prolapse gastropathy was the leading pathological finding (27%). Male gender was associated with prolapse gastropathy (OR = 3.87, p = 0.007); NSAID use predicted peptic ulcer (OR = 127.3, p < 0.001). Multivariate analysis identified abdominal pain (OR = 111.6, p < 0.001) and platelet count (p = 0.006) as independent predictors, with 97.0% model accuracy.

Conclusion

Prolapse gastropathy represents the predominant pathological cause of UGIB in children. Male gender, abdominal pain, and platelet count are significant predictors enabling evidence-based risk stratification.