Estimation of the Mortality Rate of Patients with Severe Gastroduodenal Hemorrhage with the Aid of a New Scoring System

Abstract

The widely differing mortality rates of severe gastroduodenal hemorrhage reported in the literature (10-30%), are due to very inhomogeneous patient groups. The purpose of this study was therefore to rank various clinical and endoscopical factors by giving them points from 0 to 6, both to establish comparable groups and to use them as prognostic parameters for a potential fatality rate. One hundred and ninety-three patients with severe gastroduodenal bleeding, verified at emergency gastroscopy immediately after admission, were admitted to this prospective study. The statistical assessment of the prognosis for these 8 factors revealed a linear correlation between increasing score and mortality rate for the following risk factors: patient age, activity and intensity of hemorrhage, type and number of associated illnesses, various therapeutic procedures. Only the type of the source and the site of the hemorrhage did not correlate well. By adding up the points of all risk factors for every patient we calculated the overall score and established a correlation to the mortality rate: A definite statistical correlation was demonstrated between increasing score and fatal outcome. If a patient with a score of less than 20 points did survive in 100%, the mortality rate increased linearly to 83.3% in patients with a score of 40 points. Using this scoring system it is possible to establish comparable groups of patients - which seems indispensable for a critical examination of various therapeutic procedures. Furthermore, this score can serve as a predictor of the probability of a fatal outcome shortly after patient admission.

Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

“…Although endoscopic findings can identify individuals at a high risk of rebleeding, overall mortality is often reflective of other factors such as age and comorbid conditions. In an effort to risk-stratify subjects with UGI bleeding, numerous scoring systems have been developed to predict bleeding recurrences, and the need for surgical procedures and death [17,[20][21][22][23][24][25][26][27][28] . One instrument designed for that purpose is the Rockall scoring system [27,28] .…”

“…In an effort to risk-stratify subjects with UGI bleeding, numerous scoring systems have been developed to predict bleeding recurrences, and the need for surgical procedures and death [17,[20][21][22][23][24][25][26][27][28] . One instrument designed for that purpose is the Rockall scoring system [27,28] . The Rockall system has been shown to represent an accurate and valid predictor of rebleeding and death, performing better in the latter than in the former [27][28][29] .…”

“…One instrument designed for that purpose is the Rockall scoring system [27,28] . The Rockall system has been shown to represent an accurate and valid predictor of rebleeding and death, performing better in the latter than in the former [27][28][29] . Rockall scores are designed to combine information such as the subject's age, occurrence of shock assessed from systolic blood pressure readings and pulse rate, presence and severity of comorbid conditions, diagnosis and endoscopic stigmata of recent bleeding.…”

Retrospective Review of Emergency Department Patients with Non‐variceal Upper Gastrointestinal Hemorrhage for Potential Outpatient Management

“…The data were processed and analyzed with SPSS for Windows (Release 7.5.1, SPSS Inc.). Descriptive data were used and where appropriate, 2 or t-tests were included. Missing data were not included in the final analysis.…”

Üst Gastroi̇ntesti̇nal Si̇stem Kanamalarinda Prognozu Etki̇leyen Faktörler

“…Re-endoskopi ile rekürren kanama oranı %10 dan aşağıya çekilebilmektedir (11). Ayrıca terapödik endoskopi cerrahi girişimin daha emin ve elektif koşullarda yapılmasına olanak sağlar ve böylece cerrahinin başarı şansı yükseltilebilir (12)(13)(14)(15)(16).…”