Predictors for In-hospital Mortality and Need for Clinical Intervention in Upper GI Bleeding: A 5-year Observational Study
D.V. Balaban, V. Strâmbu, B.G. Florea, A.R. Cazan, M. Brătucu, M. JingaOriginal article, no. 1, 2014
Background: Upper GI bleeding (UGIB) is a potentially lifethreateninggastrointestinal emergency whose effectivemanagement depends on early risk stratification.Methods: We retrospectively studied 151 patients admitted toour unit with UGIB between 1st January 2007 and 31stDecember 2011 and in whom we calculated the clinical andcomplete Rockall, the Glasgow-Blatchford and modifiedGlasgow-Blatchford risk scores. We performed an analysis ofthe predictive value of these scores for in-hospital mortalityand need for clinical intervention.Results: Of the 151 patients enrolled, 68.87% were male, andthe mean age was 59.48 years. One in three patients had ahistory of chronic liver disease and one in eight had a previousepisode of UGIB. Clinically, 58.3% of the patients presentedwith melena, 18.5% with hematemesis and 23.1% with bothhematemesis and melena. 22% of cases were varicealhemorrhages and the other non-variceal. 16 patients diedduring hospitalization. The prognostic accuracy of all fourscores for in-hospital death and need for clinical interventionwas good, the complete Rockall score having the bestperformance (AUROC 0.849 and 0.653 respectively).Conclusions: The Rockall and Blatchford scores were goodpredictors of mortality and need for clinical intervention in our study. The good predictive performance of these scoreshighlight the need for their use in day-to-day practice toselect patients with likelihood of poor clinical outcome.
