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

• Published in: World journal of gastroenterology : WJG 2008-08, Vol.14 (32), p.5046-5050
• Main Authors: Tammaro, Leonardo, Di Paolo, Maria-Carla, Zullo, Angelo, Hassan, Cesare, Morini, Sergio, Caliendo, Sebastiano, Pallotta, Lorella
• Format: Article
• Language: English
• Subjects: Aged; Endoscopy, Gastrointestinal - statistics & numerical data; Esophageal and Gastric Varices - epidemiology; Esophageal and Gastric Varices - pathology; Female; Humans; Incidence; Male; Middle Aged; Peptic Ulcer Hemorrhage - epidemiology; Peptic Ulcer Hemorrhage - pathology; Predictive Value of Tests; Prospective Studies; Rapid Communication; Risk Factors; 内窥镜检查; 胃溃疡; 胃肠出血; 食管血管曲张
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.14.5046

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%; 2 = 304.5309, P 〈 0.001）. Older age （t = 3.311; P 〈0.01） and presence of comorbidities （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.