A simplified clinical risk score predicts the need for early endoscopy in non-variceal upper gastrointestinal bleeding

Emanuele Sinagra, Mazzuoli, Lamboglia, Mauro Manno, Raffaele Manta, Sergio Peralta, Salvatore Camilleri, De Matthaeis, Alessandro Natali, Caliendo, Leonardo Tammaro, Occhipinti, Emanuele Sinagra, Sturniolo, Antonini, Cesare Hassan, Pallotta, Luigi Caserta, Vitale, LauriRoberto Vassallo, Testai, Cervellin, Lauri, Giacomo Carlo Sturniolo, Peccianti, D'Angelo, Elisabetta Riccio, Spotti, De Matthaeis, Kohn, Costa, De Fanis, Biagini, Di Bella, Colucci, Lauri, Azzurro, De Bona, Campaioli, De Boni, Ridolfi, Occhigrossi, Ferronato, Andrea Anderloni, Luigi Montalbano, Brunelli, Virgilio, Virgilio, Giampiero Macarri, Pozzato, Balzano, Maria Carla Di Paolo, Conigliaro, Guglielmi, Di Bella, Maurizio Ventrucci, Colucci, Giorgio Frosini, Angelo Zullo, Milani, Adamo, Antonio Craxì, Conio, Andrea Buda, Tesi, Marin, Parodi, D'Amico, Marini, Giuseppe Scarpulla

    Risultato della ricerca: Articlepeer review

    13 Citazioni (Scopus)

    Abstract

    Background: Pre-endoscopic triage of patients who require an early upper endoscopy can improve management of patients with non-variceal upper gastrointestinal bleeding. Aims: To validate a new simplified clinical score (T-score) to assess the need of an early upper endoscopy in non variceal bleeding patients. Secondary outcomes were re-bleeding rate, 30-day bleeding-related mortality. Methods: In this prospective, multicentre study patients with bleeding who underwent upper endoscopy were enrolled. The accuracy for high risk endoscopic stigmata of the T-score was compared with that of the Glasgow Blatchford risk score. Results: Overall, 602 patients underwent early upper endoscopy, and 472 presented with non-variceal bleeding. High risk endoscopic stigmata were detected in 145 (30.7%) cases. T-score sensitivity and specificity for high risk endoscopic stigmata and bleeding-related mortality was 96% and 30%, and 80% and 71%, respectively. No statistically difference in predicting high risk endoscopic stigmata between T-score and Glasgow Blatchford risk score was observed (ROC curve: 0.72 vs. 0.69, p=0.11). The two scores were also similar in predicting re-bleeding (ROC curve: 0.64 vs. 0.63, p=0.4) and 30-day bleeding-related mortality (ROC curve: 0.78 vs. 0.76, p=0.3). Conclusions: The T-score appeared to predict high risk endoscopic stigmata, re-bleeding and mortality with similar accuracy to Glasgow Blatchford risk score. Such a score may be helpful for the prediction of high-risk patients who need a very early therapeutic endoscopy
    Lingua originaleEnglish
    pagine (da-a)783-787
    Numero di pagine5
    RivistaDigestive and Liver Disease
    Volume46
    Stato di pubblicazionePublished - 2014

    All Science Journal Classification (ASJC) codes

    • ???subjectarea.asjc.2700.2721???
    • ???subjectarea.asjc.2700.2715???

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