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Journal of The Korean Society of Emergency Medicine 2025;36(4): 137-146. |
| 상부 위장관 출혈 감별에 있어서 비위관과 전산화 단층촬영의 진단적 능력 비교: 최종 진단명 또는 출혈 위치에 따른 분류 |
고재현
, 나상운
, 조영순
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| 순천향대학교 부천병원 응급의학교실 |
| Comparison of diagnostic performance between nasogastric tube and computed tomography in identifying upper gastrointestinal bleeding: subgroup analysis according to the final diagnosis or bleeding site |
| Jae Hyun Ko
, Sang Un Nah
, Young Soon Cho
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| Department of Emergency Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea |
| Correspondence |
Young Soon Cho ,Tel: 032-621-5122, Fax: 032-621-5662, Email: emer0717@gmail.com,
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Received: June 11, 2024; Revised: November 11, 2024 Accepted: April 17, 2025. Published online: August 28, 2025. |
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| ABSTRACT |
Objective:
A nasogastric (NG) tube is the common diagnostic tool for upper gastrointestinal bleeding (UGIB), but computed tomography (CT) has recently been used for differential diagnosis. Therefore, this study evaluated their utility by comparing the diagnostic accuracy of NG tube and CT in identifying UGIB.
Methods:
Retrospective data from 113 patients who visited the emergency room (ER) with suspected UGIB between January 2020 and December 2022 were analyzed. Endoscopy performed within 24 hours of the ER visit confirmed the disease type and location. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value, and area under the receiver operating characteristic curve (AUROC) were calculated to compare the two methods.
Results:
The NG tube showed higher results in identifying UGIB than CT (AUROC, 0.719 vs. 0.607). In patients with gastrointestinal cancer, however, CT had significantly higher sensitivity than the NG tube (86% vs. 71%, P=0.047). For the esophageal pathology, CT showed better specificity, accuracy, and PPV than the NG tube, with the CT showing a specificity, accuracy, and PPV of 100%, 76%, and 100%, respectively, compared to the NG tube values with a specificity, accuracy, and PPV of 95%, 74%, and 86%, respectively, with significant P-values (specificity, P=0.043; accuracy, P=0.046; PPV, P=0.034).
Conclusion:
For patients with suspected UGIB, the NG tube showed greater diagnostic utility overall than CT. Nevertheless, in patients with underlying conditions such as gastrointestinal cancer or suspected esophageal pathology, performing a CT to confirm bleeding would be helpful compared to an NG tube. |
| Key words:
Gastrointestinal hemorrhage; Computed tomography; Gastrointestinal intubation |
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