Varis dışı Üst Gastrointestinal Sistem Kanamalı Hastalarda Klinik Seyri Öngörmede Endoskopi Öncesi Risk Skorlarının Etkinliği.

Aim: Upper gastrointestinal bleeding (UGK) is one of the leading causes of emergency department admissions and hospitalizations. Various risk scores are used to predict the need for invasive treatment (endoscopic hemostasis, blood transfusion, surgical management), rebleeding, and mortality at the time of admission. Our study aims to compare the performance of preendoscopic Rockall (pRS), Glasgow-Blatchford bleeding (GBS), and AIMS-65 scores before endoscopy in predicting high-risk groups. Methods: Patients who were admitted to the emergency department between January 2015 and June 2016 and were diagnosed as non-variceal UGR after clinical, laboratory, and/or endoscopic evaluation were retrospectively screened. Demographic and clinical characteristics, laboratory values, scoring points, endoscopic intervention, and clinical course (blood transfusion, rebleeding, surgical management, death) were recorded. Results: 163 patients (79% male) with a median age of 57.2± 18.7 years were included in the study. To stop bleeding, endoscopic intervention was performed in 92 patients (56.4%) and surgical intervention was performed in 6 patients (3.7%). Rebleeding occurred in 9.2% of the patients (15 patients). 63.8% (104 patients) received a blood transfusion. The mortality rate was 2.5% (4 patients). AIMS-65 score was found to be superior to others in predicting mortality (AUROC= 0.892, p=0.007). GBS was found to be superior to others in predicting rebleeding, blood transfusion, and surgical management (AUROC=0.697, p=0.012; AUROC=0.778, p<0.001, and AUROC=0.851, p=0.004, respectively). pRS and AIMS-65 are similarly effective in predicting endoscopic intervention and are superior to GBS (AUROC=0.379, p=0.008 and AUROC=0.378, p=0.008, respectively). Conclusion: The AIMS-65 score was identified to be superior in predicting mortality. GBS score was identified to be superior in predicting rebleeding, blood transfusion, and the need for surgery. None of the scores were effective in predicting endoscopic intervention. The combined use of GBS and AIMS-65 can be useful in determining UGK with the high-risk group in the emergency department. [ABSTRACT FROM AUTHOR]