Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis
Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65)...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Chandnani, Sanjay [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Anmerkung: |
© Indian Society of Gastroenterology 2019 |
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| Übergeordnetes Werk: |
Enthalten in: Indian Journal of Gastroenterology - Springer-Verlag, 2009, 38(2019), 2 vom: Apr., Seite 117-127 |
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| Übergeordnetes Werk: |
volume:38 ; year:2019 ; number:2 ; month:04 ; pages:117-127 |
| Links: |
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| DOI / URN: |
10.1007/s12664-019-00951-w |
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| Katalog-ID: |
SPR026662892 |
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| 520 | |a Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. | ||
| 650 | 4 | |a Endoscopy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Non-variceal bleed |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Risk scores |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Upper gastrointestinal bleeding |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Variceal bleed |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Jain, Shubham |4 aut | |
| 700 | 1 | |a Contractor, Qais |4 aut | |
| 700 | 1 | |a Jain, Samit |4 aut | |
| 700 | 1 | |a Singh, Anupam Kumar |4 aut | |
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10.1007/s12664-019-00951-w doi (DE-627)SPR026662892 (SPR)s12664-019-00951-w-e DE-627 ger DE-627 rakwb eng Chandnani, Sanjay verfasserin aut Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2019 Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 Rathi, Pravin aut Sonthalia, Nikhil aut Udgirkar, Suhas aut Jain, Shubham aut Contractor, Qais aut Jain, Samit aut Singh, Anupam Kumar aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 38(2019), 2 vom: Apr., Seite 117-127 (DE-627)SPR02665167X nnns volume:38 year:2019 number:2 month:04 pages:117-127 https://dx.doi.org/10.1007/s12664-019-00951-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2019 2 04 117-127 |
| spelling |
10.1007/s12664-019-00951-w doi (DE-627)SPR026662892 (SPR)s12664-019-00951-w-e DE-627 ger DE-627 rakwb eng Chandnani, Sanjay verfasserin aut Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2019 Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 Rathi, Pravin aut Sonthalia, Nikhil aut Udgirkar, Suhas aut Jain, Shubham aut Contractor, Qais aut Jain, Samit aut Singh, Anupam Kumar aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 38(2019), 2 vom: Apr., Seite 117-127 (DE-627)SPR02665167X nnns volume:38 year:2019 number:2 month:04 pages:117-127 https://dx.doi.org/10.1007/s12664-019-00951-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2019 2 04 117-127 |
| allfields_unstemmed |
10.1007/s12664-019-00951-w doi (DE-627)SPR026662892 (SPR)s12664-019-00951-w-e DE-627 ger DE-627 rakwb eng Chandnani, Sanjay verfasserin aut Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2019 Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 Rathi, Pravin aut Sonthalia, Nikhil aut Udgirkar, Suhas aut Jain, Shubham aut Contractor, Qais aut Jain, Samit aut Singh, Anupam Kumar aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 38(2019), 2 vom: Apr., Seite 117-127 (DE-627)SPR02665167X nnns volume:38 year:2019 number:2 month:04 pages:117-127 https://dx.doi.org/10.1007/s12664-019-00951-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2019 2 04 117-127 |
| allfieldsGer |
10.1007/s12664-019-00951-w doi (DE-627)SPR026662892 (SPR)s12664-019-00951-w-e DE-627 ger DE-627 rakwb eng Chandnani, Sanjay verfasserin aut Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2019 Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 Rathi, Pravin aut Sonthalia, Nikhil aut Udgirkar, Suhas aut Jain, Shubham aut Contractor, Qais aut Jain, Samit aut Singh, Anupam Kumar aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 38(2019), 2 vom: Apr., Seite 117-127 (DE-627)SPR02665167X nnns volume:38 year:2019 number:2 month:04 pages:117-127 https://dx.doi.org/10.1007/s12664-019-00951-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2019 2 04 117-127 |
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10.1007/s12664-019-00951-w doi (DE-627)SPR026662892 (SPR)s12664-019-00951-w-e DE-627 ger DE-627 rakwb eng Chandnani, Sanjay verfasserin aut Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2019 Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 Rathi, Pravin aut Sonthalia, Nikhil aut Udgirkar, Suhas aut Jain, Shubham aut Contractor, Qais aut Jain, Samit aut Singh, Anupam Kumar aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 38(2019), 2 vom: Apr., Seite 117-127 (DE-627)SPR02665167X nnns volume:38 year:2019 number:2 month:04 pages:117-127 https://dx.doi.org/10.1007/s12664-019-00951-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2019 2 04 117-127 |
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Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. 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Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis Endoscopy (dpeaa)DE-He213 Non-variceal bleed (dpeaa)DE-He213 Risk scores (dpeaa)DE-He213 Upper gastrointestinal bleeding (dpeaa)DE-He213 Variceal bleed (dpeaa)DE-He213 |
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comparison of risk scores in upper gastrointestinal bleeding in western india: a prospective analysis |
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Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis |
| abstract |
Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. © Indian Society of Gastroenterology 2019 |
| abstractGer |
Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. © Indian Society of Gastroenterology 2019 |
| abstract_unstemmed |
Aim To study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age > 65 (AIMS65) risk scores in predicting outcomes in patients with UGIB. Methods Three hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30 days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated. Results The mean age was 43.5 ± 17.2 years, and 207 (69%) were males. Hematemesis was the most common presentation (94%). Variceal bleeding was the most common etiology (47.7%). Thirty patients died (10%) and 50 had rebleeding (16.7%). On univariate analysis, serum albumin ≤ 2.7 gm% (p = 0.008), Glasgow Coma scale ≤ 13.9 (p = 0.001), serum bilirubin > 3 mg/dL (p = 0.004), serum bicarbonate ≤ 15.7 mEq/L (p = 0.001), systolic blood pressure < 90 mmHg (p = 0.004), and arterial pH ≤ 7.3 (p = 0.003) were found to be the predictors of mortality. No variable was found significant on multivariate analysis. All four scores were significant in predicting mortality, but Rockall (area under receiver operating characteristic [AUROC] 0.728) was better than others. Rebleeding was better predicted by PNED (modified) (AUROC 0.705). In predicting the need for transfusion and surgical or radiological intervention, GBS score > 0 was significant while score of < 2 classified patients into low risk for mortality with high negative predictive value. Conclusion Our study showed that the variceal bleeding was the commonest cause of UGIB. Rockall score was more significant in predicting mortality while PNED for rebleeding. Low risk for mortality, need for blood transfusion, or interventions were accurately predicted by GBS. © Indian Society of Gastroenterology 2019 |
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