Prospective validation of the Glasgow Blatchford scoring system in patients with upper gastrointestinal bleeding in the emergency department

2012 ◽  
Vol 23 (5) ◽  
pp. 448-455 ◽  
Author(s):  
Ozlem KOKSAL ◽  
Gulden OZEREN ◽  
Fatma OZDEMIR ◽  
Erol ARMAGAN ◽  
Sule AYDIN ◽  
...  
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

Development, Validation, and Comparative Assessment of an International Scoring System to Determine Risk of Upper Gastrointestinal Bleeding

2019 ◽  
Vol 17 (6) ◽  
pp. 1121-1129.e2 ◽  
Author(s):  
Kathryn Oakland ◽  
Brennan C. Kahan ◽  
Leonardo Guizzetti ◽  
Myriam Martel ◽  
Robert V. Bryant ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Comparative Assessment ◽  
Upper Gastrointestinal

scholarly journals Clinical profile of patients presenting to emergency with upper gastrointestinal bleeding in a tertiary hospital of Nepal

2021 ◽  
Vol 8 (2) ◽  
pp. 105-111
Author(s):  
Sunil Adhikari ◽  
Suraj Rijal ◽  
Darlene Rose House
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Clinical Presentation ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Hospital ◽  
Clinical Profile ◽  
Ulcer Bleeding ◽  
Cross Sectional ◽  
Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.

scholarly journals Prediction model of emergency mortality risk in patients with acute upper gastrointestinal bleeding: a retrospective study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11656
Author(s):  
Lan Chen ◽  
Han Zheng ◽  
Saibin Wang
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Area Under The Curve ◽  
Decision Curve Analysis ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Bleeding Score ◽  
Selection Operator ◽  
Upper Gastrointestinal ◽  
D Dimer

Background Upper gastrointestinal bleeding is a common presentation in emergency departments and carries significant morbidity worldwide. It is paramount that treating physicians have access to tools that can effectively evaluate the patient risk, allowing quick and effective treatments to ultimately improve their prognosis. This study aims to establish a mortality risk assessment model for patients with acute upper gastrointestinal bleeding at an emergency department. Methods A total of 991 patients presenting with acute upper gastrointestinal bleeding between July 2016 and June 2019 were enrolled in this retrospective single-center cohort study. Patient demographics, parameters assessed at admission, laboratory test, and clinical interventions were extracted. We used the least absolute shrinkage and selection operator regression to identify predictors for establishing a nomogram for death in the emergency department or within 24 h after leaving the emergency department and a corresponding nomogram. The area under the curve of the model was calculated. A bootstrap resampling method was used to internal validation, and decision curve analysis was applied for evaluate the clinical utility of the model. We also compared our predictive model with other prognostic models, such as AIMS65, Glasgow-Blatchford bleeding score, modified Glasgow-Blatchford bleeding score, and Pre-Endoscopic Rockall Score. Results Among 991 patients, 41 (4.14%) died in the emergency department or within 24 h after leaving the emergency department. Five non-zero coefficient variables (transfusion of plasma, D-dimer, albumin, potassium, age) were filtered by the least absolute shrinkage and selection operator regression analysis and used to establish a predictive model. The area under the curve for the model was 0.847 (95% confidence interval [0.794–0.900]), which is higher than that of previous models for mortality of patients with acute upper gastrointestinal bleeding. The decision curve analysis indicated the clinical usefulness of the model. Conclusions The nomogram based on transfusion of plasma, D-dimer, albumin, potassium, and age effectively assessed the prognosis of patients with acute upper gastrointestinal bleeding presenting at the emergency department.

scholarly journals MAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding

2019 ◽  
Vol 35 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Eduardo Redondo‐Cerezo ◽  
Francisco Vadillo‐Calles ◽  
Adrian J Stanley ◽  
Stig Laursen ◽  
Loren Laine ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal ◽  
New Scoring

scholarly journals Modification of Glasgow-Blatchford scoring with lactate in predicting the mortality of patients with upper gastrointestinal bleeding in emergency department

2018 ◽  
Vol 26 (1) ◽  
pp. 31-38
Author(s):  
Zeynep Konyar ◽  
Ozlem Guneysel ◽  
Fatma Sari Dogan ◽  
Eren Gokdag
Keyword(s):  
Emergency Department ◽  
Blood Transfusion ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Venous Blood ◽  
Erythrocyte Suspension ◽  
Laboratory Findings ◽  
Significant Difference ◽  
Lactate Levels ◽  
Upper Gastrointestinal

Background: Gastrointestinal bleeding is a commonly seen multidisciplinary clinical condition in emergency departments which has high treatment cost and mortality in company with hospital admission. Risk evaluation before endoscopy is based on clinical and laboratory findings at patient’s emergency visit. Objective: The purpose of this study is to investigate the efficacy of “Glasgow-Blatchford scale + lactate levels” to predict the mortality of patients detected with gastrointestinal bleeding in the emergency department. Methods: A total of 107 patients with preliminary diagnosis of upper gastrointestinal bleeding included in the study after approval of the ethics committee were prospectively evaluated. Glasgow-Blatchford scale scores were calculated and venous blood lactate levels were assessed. Need for blood transfusion in the follow-up, the amount of transfusion, and mortality in the next 6 months were evaluated. Results: A statistically significant difference was found in mortality rates between the lactate and Glasgow-Blatchford scale cohorts in our study (p = 0.001 and p < 0.01, respectively). The mortality rate was significantly higher in the lactate(+) GBS(+) cases compared to the lactate(–) GBS(+), lactate(+) GBS(–), and lactate(–) GBS(–) cases compared to the bilateral comparisons (p = 0.004, p = 0.001, p = 0.001, and p < 0.01, respectively). There was a statistically significant relationship between the rate of erythrocyte suspension replacement in the cases according to Glasgow-Blatchford scale levels (p = 0.001 and p < 0.01, respectively). The incidence of erythrocyte suspension replacement was 7.393 times greater in patients with Glasgow-Blatchford scale score of 12 and above. Conclusion: Glasgow-Blatchford scale is highly sensitive to the determination of mortality risk and the need for blood transfusion in upper gastrointestinal bleeding. Glasgow-Blatchford scale with lactate evaluation is more sensitive and more significant than Glasgow-Blatchford scale alone. This significance provides us to establish “modified Glasgow-Blatchford scale.” In the future, studies which will use Glasgow-Blatchford scale supported by lactate could be increased and the results should be supported more.

scholarly journals Validation of a New Risk Score System for Non-variceal Upper Gastrointestinal Bleeding

2020 ◽  
Author(s):  
Min Seong Kim ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Jae Ho Park ◽  
Ju Seok Kim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Gastrointestinal Bleeding ◽  
Hospital Stay ◽  
Roc Curve ◽  
Scoring System ◽  
Operating Characteristic ◽  
Upper Gastrointestinal Bleeding ◽  
Bleeding Score ◽  
Upper Gastrointestinal ◽  
New Scoring

Abstract Background: Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure.Methods: A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.Results: The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806-0.856; P<0.001), PNED (AUROC, 0.865; 95%CI, 0.841-0.886; P<0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774-0.827; P<0.001), and GBS (AUROC, 0.765; 95%CI, 0.736-0.793; P <0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 hours during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed.Conclusion: The new international bleeding score could predict 30-day mortality better than the other scoring systems. High-risk patients can be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seems to improve the outcomes of non-variceal UGIB patients through proper management and intervention.

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