Prediction of outcome of acute G1 hemorrhage: a review of risk scores and predictive models

For patients with acute GI hemorrhage, risk stratification with respect to adverse outcome is a logical strategy, both for triage of those at high risk to inpatient care and for identification of patients at low risk of adverse outcome who can be safely managed on an outpatient basis. Although a number of risk scores and prediction models have been developed for patients with acute GI hemorrhage, except for research studies, none has gained widespread clinical application. If risk scores are to evolve into useful clinical decision aids, they will have to be more user friendly, accurate, portable, and widely applicable in diverse clinical situations. The acid test for the practical use of any such risk-stratification system lies in a demonstrated ability to positively and significantly impact the cost-effective care of patients, and, at the same time, to improve the overall quality of care, which hopefully will reduce the incidence of recurrent bleeding and mortality rate.