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A simplified clinical risk score predicts the need for early endoscopy in non-variceal upper gastrointestinal bleeding.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2014 Sep; Vol. 46 (9), pp. 783-7. Date of Electronic Publication: 2014 Jun 20. - Publication Year :
- 2014
-
Abstract
- Background: Pre-endoscopic triage of patients who require an early upper endoscopy can improve management of patients with non-variceal upper gastrointestinal bleeding.<br />Aims: To validate a new simplified clinical score (T-score) to assess the need of an early upper endoscopy in non variceal bleeding patients. Secondary outcomes were re-bleeding rate, 30-day bleeding-related mortality.<br />Methods: In this prospective, multicentre study patients with bleeding who underwent upper endoscopy were enrolled. The accuracy for high risk endoscopic stigmata of the T-score was compared with that of the Glasgow Blatchford risk score.<br />Results: Overall, 602 patients underwent early upper endoscopy, and 472 presented with non-variceal bleeding. High risk endoscopic stigmata were detected in 145 (30.7%) cases. T-score sensitivity and specificity for high risk endoscopic stigmata and bleeding-related mortality was 96% and 30%, and 80% and 71%, respectively. No statistically difference in predicting high risk endoscopic stigmata between T-score and Glasgow Blatchford risk score was observed (ROC curve: 0.72 vs. 0.69, p=0.11). The two scores were also similar in predicting re-bleeding (ROC curve: 0.64 vs. 0.63, p=0.4) and 30-day bleeding-related mortality (ROC curve: 0.78 vs. 0.76, p=0.3).<br />Conclusions: The T-score appeared to predict high risk endoscopic stigmata, re-bleeding and mortality with similar accuracy to Glasgow Blatchford risk score. Such a score may be helpful for the prediction of high-risk patients who need a very early therapeutic endoscopy.<br /> (Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Diagnosis, Differential
Female
Follow-Up Studies
Gastrointestinal Hemorrhage epidemiology
Humans
Incidence
Italy epidemiology
Male
Middle Aged
Prospective Studies
ROC Curve
Recurrence
Reproducibility of Results
Risk Factors
Severity of Illness Index
Survival Rate trends
Early Diagnosis
Endoscopy, Gastrointestinal methods
Gastrointestinal Hemorrhage diagnosis
Risk Assessment methods
Triage methods
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 46
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 24953205
- Full Text :
- https://doi.org/10.1016/j.dld.2014.05.006