Emergency diagnosis of upper gastrointestinal bleeding by detection of haemoglobin in nasogastric aspirate

Objective To determine the accuracy of the Faecal Occult Blood-Transferrin test (FOB-T; Certest Biotec, San Mateo de Gallego, Spain) for detection of blood in nasogastric aspirate, and its emergency diagnostic value for upper gastrointestinal bleeding (UGIB). Methods Nasogastric aspirate was collected from patients with haematemesis on admission to hospital. Haemoglobin was quantified on admission and after 12h. FOB-T test was used to assess each nasogastric aspirate sample for the presence of haemoglobin and transferrin. Results Of 64 patients included in the study, 28 (43.8%) were hospitalized for UGIB based on physical examination, haemoglobin level. 24 were confirmed with endoscopy findings. Four were excluded from study due to lack of endoscopic confirmation. The remaining 36 patients had no clinical evidence of UGIB. FOB-T test findings were positive in 26/60 patients, including all 24 patients with UGIB. The FOB-T test had sensitivity 100%, specificity 94.4%, positive predictive value 92.3% and negative predictive value 100% for UGIB. Conclusions A negative FOB-T test may be sufficient to exclude the possibility of UGIB without other diagnostic tests.