Upper gastrointestinal hemorrhage re-bleeding risk according to the Glasgow-Blatchford scale: a triage tool

被引:0
作者
Olivarec-Bonilla, Miroslava [1 ]
Garcia-Montano, Anaidt M. [1 ]
Herrera-Arellano, Armando [2 ]
机构
[1] Hosp Gen Reg 1, Inst Mexicano Seguro Social, Serv Urgencias Adultos, Cuernavaca, Morelos, Mexico
[2] Univ Autonoma Estado Morelos, Fac Med, Cuernavaca, Morelos, Mexico
来源
GACETA MEDICA DE MEXICO | 2020年 / 156卷 / 06期
关键词
Upper gastrointestinal hemorrhage; Re-bleeding risk; Endoscopy; Glasgow-Blatchford scale; Forrest scale; Dagradi scale; FORREST CLASSIFICATION; MORTALITY; SCORE; MANAGEMENT; CONSENSUS; OUTCOMES;
D O I
10.24875/GMM.20005607
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The Glasgow-Blatchford scale (GBS) classifies the risk of re-bleeding after upper gastrointestinal bleeding (UGIB) using clinical data, whereas the Forrest and Dagradi scales do it by endoscopy. Objective: To assess GBS's ability to identify re-bleeding risk within 30 days of an UGIB, using endoscopy as the gold standard for comparison. Method: 129 medical records of patients with UGIB and endoscopy were analyzed. The Glasgow-Blatchford, Forrest and Dagradi scales were quantified; sensitivity, specificity and area under the ROC curve (AUC-ROC) of GBS-reported re-bleeding risk were calculated. Results: GBS identified 53 patients with low re-bleeding risk (41.09 %) and 76 with high risk (58.91 %). Endoscopy identified 107 patients with non-variceal bleeding (82.94 %): 98 with low risk (89.9 %) and 11 with high risk (10.09 %); in addition, it identified 22 patients with variceal hemorrhage (17.05 %): 12 with low risk (54.54 %) and 10 with high risk (45.45 %). GBS showed a sensitivity of 0.857, specificity of 0.462 and an AUC- ROC of 0.660. Conclusions: GBS is simple, objective and useful to identify the risk of re-bleeding after UGIB; it is suggested as a triage tool in the emergency department.
引用
收藏
页码:502 / 508
页数:7
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