Evaluation of serum diamine oxidase levels in patients diagnosis of upper gastrointestinal system bleeding in the emergency department

Acute gastrointestinal bleeding is an emergency condition that requires hospitalization and can be associated with high morbidity and mortality. Depending on the bleeding location in the gastrointestinal system, bleeding originating from the proximal part of the ligament of Treitz is defined as upper gastrointestinal bleeding, while bleeding originating from the distal part of the ligament is defined as lower gastrointestinal bleeding. When gastrointestinal bleeding is suspected, a detailed history, evaluation of vital signs, general physical examination including rectal examination, and various laboratory tests are important in the diagnostic process. There is a need for guiding parameters in determining morbidity and mortality by determining the need for early blood transfusion, endoscopic intervention and surgical procedure in patients diagnosed with upper gastrointestinal bleeding in emergency departments; and also determining patient groups that do not require hospitalization and intervention and have a very low risk of rebleeding. Serum diamine oxidase enzyme is an enzyme that reflects intestinal mucosal damage at an early stage and effectively shows the situations in which intestinal defense function is impaired. In our study, between the dates 04.06.2024 and 15.08.2024, the demographic data, clinical findings, laboratory tests and serum diamine oxidase levels of 56 patients diagnosed with upper gastrointestinal system bleeding who met our study criteria and were divided into two groups based on vascular volume status, as well as 28 healthy volunteers, were examined at the Emergency Department of Trakya University Medical Faculty Health Application and Research Center. The impact of these data on disease severity and mortality determination was investigated. In our study, the mean age was 65.23±15.9 in Group I, 72.65±9.86 in Group II, and 59.54±17.12 in the healthy group. Median diamine oxidase enzyme values were 6.1 (5.1-17.45) in Group I, 36.55 (30.6-44.18) in Group II, and 14.55 (5.88-18.05) in Group III. Serum diamine oxidase values were higher in Group II (p<0.001). Serum diamine oxidase enzyme was found to be significantly higher in predicting mortality in Group I (95% Confidence interval: 1.00-1.00, p=0.020) and Group II (95% Confidence interval: 0.65-0.98, p=0.011). Keywords: acute upper gastrointestinal bleeding, serum diamine oxidase enzyme, mortality