Original articleClinical endoscopyPerformance of the Glasgow-Blatchford score in predicting clinical outcomes and intervention in hospitalized patients with upper GI bleeding
Section snippets
Methods
A prospective study was performed on consecutive hospitalized patients who were referred to the Gastroenterology Service of the Royal Adelaide Hospital for the management of upper GI hemorrhage over 24 months, from July 2010 to July 2012. Upper GI hemorrhage was defined as bleeding from the upper GI tract as manifest by hematemesis (including coffee-ground vomiting) and/or melena. Variceal and nonvariceal causes of upper GI hemorrhage were included in the analysis. Patients were followed during
Results
A total of 888 (560 men; aged 66.2 ± 0.6 years) hospitalized patients were managed for upper GI hemorrhage by the Gastroenterology Service of the Royal Adelaide Hospital over 24 months. The presenting symptoms were melena (n = 467, 52.6%), hematemesis (n = 238, 26.8%), and both hematemesis and melena (n = 183, 20.6%). Endoscopy was performed in 708 patients (79.7%) (459 men; aged 65.6 ± 0.6 years), with 103 patients (11.6%) undergoing repeated endoscopy for rebleeding. Blood transfusion was
Discussion
Our data show that the GBS is superior to the pre-E RS in predicting the need for endoscopic therapy and is superior to both the pre-E and post-E Rockall scores in predicting the need for blood transfusion and surgery in hospitalized patients with upper GI hemorrhage. Our study also shows that a GBS score of ≤3 identifies patients who do not require endoscopic intervention, transfusion, or surgery, suggesting that these patients can be discharged early with conservative management and
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 637.