CHAPTER 4 DIAGNOSTIC NASOGASTRIC TUBES IN HEMATEMESIS

Usefulness and Validity of Diagnostic Nasogastric Aspiration in Patients Without Hematemesis

Witting MD, Magder L, Heins AE, et al. Ann Emerg Med. 2004;43:525–532

BACKGROUND

GI bleeding is a common ED presentation with significant associated morbidity and mortality. It is often difficult to distinguish upper and lower GI sources of bleeding, though this can have significant treatment implications. Nasogastric (NG) aspiration has long been thought of as one way to emergently differentiate upper and lower sources of GI bleeding. At the time of this study, it was not known whether knowledge gained from NG aspiration actually influences emergent management and outweighs patient discomfort and complications, such as tube misplacement and aspiration.

OBJECTIVES

To estimate the test characteristics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], likelihood ratio [LR]) of NG aspiration to diagnose upper GI bleed in ED patients without hematemesis.

METHODS

Retrospective cohort study at two urban hospitals between 1997 and 2002.

Patients

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