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Dtsch Med Wochenschr. 2013 May;138(21):1096-101. doi: 10.1055/s-0033-1343134. Epub 2013 May 15.

[Pre-endoscopic assessment to predict outcome of acute upper gastrointestinal bleeding--a retrospective study in patients subject to emergency endoscopy outside regular working hours].

[Article in German]

Author information

  • 1Zentrale Patientenaufnahme, Marienhospital Herne, Klinikum der Ruhr-Universität Bochum. arnd.giese@rub.de

Abstract

BACKGROUND AND OBJECTIVES:

To evaluate the predictive value of pre-endoscopic risk scores in patients with upper gastrointestinal bleeding (UGI-B).

PATIENTS AND METHODS:

The medical records of patients evaluated by emergency esophago-gastro-duodenoscopy (E-EGD) for suspected UGI-B outside regular working hours were retrospectively analysed.

RESULTS:

During the 75 months of the study period 112 E-EGDs met the inclusion criteria. Mean age was 65.5 ± 14.7 years. 38.4 % of patients were female. Endoscopy revealed 41 gastro-duodenal ulcers, 16 Mallory-Weiss, 13 varices, 4 neoplasia. 72 patients received transfusions, 39 had endoscopic interventions. 2 patients were surgically treated, 16 had recurrent bleeding. 16 of the 110 patients died during hospitalisation. The following sensitivities were found for the Blatchford score (cut-off > 1), the clinical Rockall score (cut-off > 0) and the Adamopoulos score (cut-off > 2) in predicting need for clinical intervention (endoscopic or surgical intervention or transfusion): 100/97.7/93%, recurrent bleeding: 100/100/93.8%, in-hospital mortality: 100/93.8/93.8%, respectively.

CONCLUSIONS:

The Blatchford score is a suitable tool in determining the need for clinical intervention and the risk of recurrent bleeding and death in patients with UGI-B. The clinical Rockall score and the Adamopoulos score (the latter had originally been developed to predict active UGI-B at endoscopy and was used with a lower cut-off in our study) are inferior alternatives.

© Georg Thieme Verlag KG Stuttgart · New York.

PMID:
23677503
[PubMed - indexed for MEDLINE]
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