Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy

Abstract

AIM:To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy. METHODS: All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis. RESULTS: Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haemorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; c 2 = 304.5309, P < 0.001). Older age (t = 3.311; P < 0.01) and presence of comorbidities (c 2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients. CONCLUSION: Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further, randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.

The clinical significance of upper gastrointestinal bleeding etiology score in determining variceal bleeding

“…It has been reported previously that UGIB patients are predominantly male (ranging between 60% -80%) [11,12], and comparably, in our study, we found that 56% of all patients were male.…”

“…Likewise, Tammaro L. et al [12] also revealed an older age of their patients; the mean age of their patients was 65 years. Similarly, our study showed that the majority of UGIB cases presented in the later stages of life.…”

A survey on mortality from non-variceal upper gastrointestinal bleeding: Is the emergency referral system adequate?

“…As a result, a number of scoring systems have been developed for these patients [7,[9][10][11]. Moreover, surveys have been conducted in different countries to assess local standard treatment features [12][13][14].…”

Upper gastrointestinal bleeding risk scores: Who, when and why?

“…The T-score can be used to triage patients who are likely to have high-risk endoscopic stigmata and therefore need intervention [24] . It has the ability to predict high-risk endoscopic stigmata, rebleeding and mortality with an accuracy similar to the GBS [65] .…”

“…An Italian study developed the T-score which included 4 clinical parameters commonly assessed in the UGIB setting: (1) general conditions (poor, intermediate, good); (2) pulse (< 90 beats/min, 90-110 beats/min, > 110 beats/min); (3) systolic blood pressure (< 90 mmHg, 90-110 mmHg, > 110 mmHg); and (4) haemoglobin level (≤ 8 g/dL, 9-10 g/dL, > 10 g/dL) [24] (Table 7).…”