The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings
Objective:Upper gastrointestinal (GI) bleeding is a major reason of mortality and morbidity today, and patients’ follow-up and treatment costs are still high. In our study, the values of risk scorings of the patients with upper GI bleeding in estimation of mortality and morbidity were evaluated.Meth...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2021-06-01
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| Series: | Bagcilar Medical Bulletin |
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http://behmedicalbulletin.org/archives/archive-detail/article-preview/the-evaulation-of-risk-scorings-in-non-variceal-up/47540
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| author | Faik Özel Elif Yorulmaz Hatice Yorulmaz Can Davutoğlu Aytekin Güven |
| author_facet | Faik Özel Elif Yorulmaz Hatice Yorulmaz Can Davutoğlu Aytekin Güven |
| author_sort | Faik Özel |
| collection | DOAJ |
| description | Objective:Upper gastrointestinal (GI) bleeding is a major reason of mortality and morbidity today, and patients’ follow-up and treatment costs are still high. In our study, the values of risk scorings of the patients with upper GI bleeding in estimation of mortality and morbidity were evaluated.Method:One hundred sixty-nine patients who were admitted to emergency internal medicine in University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital Clinic of Internal Medicine due to the diagnosis of upper GI bleeding were reviewed retrospectively between January 2015 and January 2016 in the study. Patients with upper GI bleeding due to varices (esophageal and gastric) endoscopically were excluded from the study. Forrest scoring’s classification was made according to the endoscopic findings. Classification of bleeding ulcers according to their appearance is as follows; Forrest 1a; ‘‘gushing active bleeding’’, Forrest 1b; ‘‘oozing active bleeding’’, Forrest 2a; ‘‘visible non-bleeding vein’’, Forrest 2b; ‘‘adherent clot’’, Forrest 2c; ‘‘flat pigmented lesion’’, Forrest 3; ‘‘no evidence of bleeding’’. Rockall scoring’s classification uses clinical criteria (pulse, age, systolic blood pressure, comorbidity) in addition to endoscopic findings (diagnosis, hemorrhage). Accordingly, a score less than 3 carries good prognosis. Glasgow-Blatchford scoring’s classification was calculated according to the situation of urea nitrogen, hemoglobin, systolic blood pressure, pulse, melena occurrence, syncope, and hepatic or cardiac problems. In this scoring, patients may be in the range of 0-23 points and the need for endoscopic intervention increases according to rising in the score.Results:The average age of the participants in the study was 57.39±19.14 years. 72% of the cases (n=121) were male. While the presence of melena was observed in 88.7% of the cases, it was seen that 61.9% of the cases had peptic ulcer and 12.5% of the general surgery consultation was performed. It was determined that there was no statistically significant difference in the Forrest classifications of the cases in terms of hospitalization duration and blood transfusion (p>0.05). Rockall and Glasgow-Blatchford scores were statistically remarkably higher in patients with hospitalization duration, need for blood transfusion, rebleeding, intensive care follow-up, surgical intervention, and mortality (p<0.05).Conclusion:The association of Rockall and Glasgow-Blatchford risk scores with morbidity and mortality rates showed that patients should not be interpreted solely according to their endoscopic images. These scorings can be used in approach toward patients with Upper GI bleeding in comprehensive prospective studies. |
| first_indexed | 2024-04-10T14:15:49Z |
| format | Article |
| id | doaj.art-d958bda0fa2a40af8ee0b2a5ece91bbe |
| institution | Directory Open Access Journal |
| issn | 2547-9431 |
| language | English |
| last_indexed | 2024-04-10T14:15:49Z |
| publishDate | 2021-06-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Bagcilar Medical Bulletin |
| spelling | doaj.art-d958bda0fa2a40af8ee0b2a5ece91bbe2023-02-15T16:09:32ZengGalenos YayineviBagcilar Medical Bulletin2547-94312021-06-016218318910.4274/BMB.galenos.2021.11.08113049054The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal BleedingsFaik Özel0Elif Yorulmaz1Hatice Yorulmaz2Can Davutoğlu3Aytekin Güven4 University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Internal Medicine, İstanbul, Turkey University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Gastroenterology, İstanbul, Turkey Haliç University Faculty of Health Sciences, Department of Nursing, İstanbul, Turkey University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Gastroenterology, İstanbul, Turkey University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Internal Medicine, İstanbul, Turkey Objective:Upper gastrointestinal (GI) bleeding is a major reason of mortality and morbidity today, and patients’ follow-up and treatment costs are still high. In our study, the values of risk scorings of the patients with upper GI bleeding in estimation of mortality and morbidity were evaluated.Method:One hundred sixty-nine patients who were admitted to emergency internal medicine in University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital Clinic of Internal Medicine due to the diagnosis of upper GI bleeding were reviewed retrospectively between January 2015 and January 2016 in the study. Patients with upper GI bleeding due to varices (esophageal and gastric) endoscopically were excluded from the study. Forrest scoring’s classification was made according to the endoscopic findings. Classification of bleeding ulcers according to their appearance is as follows; Forrest 1a; ‘‘gushing active bleeding’’, Forrest 1b; ‘‘oozing active bleeding’’, Forrest 2a; ‘‘visible non-bleeding vein’’, Forrest 2b; ‘‘adherent clot’’, Forrest 2c; ‘‘flat pigmented lesion’’, Forrest 3; ‘‘no evidence of bleeding’’. Rockall scoring’s classification uses clinical criteria (pulse, age, systolic blood pressure, comorbidity) in addition to endoscopic findings (diagnosis, hemorrhage). Accordingly, a score less than 3 carries good prognosis. Glasgow-Blatchford scoring’s classification was calculated according to the situation of urea nitrogen, hemoglobin, systolic blood pressure, pulse, melena occurrence, syncope, and hepatic or cardiac problems. In this scoring, patients may be in the range of 0-23 points and the need for endoscopic intervention increases according to rising in the score.Results:The average age of the participants in the study was 57.39±19.14 years. 72% of the cases (n=121) were male. While the presence of melena was observed in 88.7% of the cases, it was seen that 61.9% of the cases had peptic ulcer and 12.5% of the general surgery consultation was performed. It was determined that there was no statistically significant difference in the Forrest classifications of the cases in terms of hospitalization duration and blood transfusion (p>0.05). Rockall and Glasgow-Blatchford scores were statistically remarkably higher in patients with hospitalization duration, need for blood transfusion, rebleeding, intensive care follow-up, surgical intervention, and mortality (p<0.05).Conclusion:The association of Rockall and Glasgow-Blatchford risk scores with morbidity and mortality rates showed that patients should not be interpreted solely according to their endoscopic images. These scorings can be used in approach toward patients with Upper GI bleeding in comprehensive prospective studies. http://behmedicalbulletin.org/archives/archive-detail/article-preview/the-evaulation-of-risk-scorings-in-non-variceal-up/47540 risk assesmentrisk scoresupper gi bleeding |
| spellingShingle | Faik Özel Elif Yorulmaz Hatice Yorulmaz Can Davutoğlu Aytekin Güven The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings Bagcilar Medical Bulletin risk assesment risk scores upper gi bleeding |
| title | The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings |
| title_full | The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings |
| title_fullStr | The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings |
| title_full_unstemmed | The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings |
| title_short | The Evaulation of Risk Scorings in Non-variceal Upper Gastrointestinal Bleedings |
| title_sort | evaulation of risk scorings in non variceal upper gastrointestinal bleedings |
| topic | risk assesment risk scores upper gi bleeding |
| url |
http://behmedicalbulletin.org/archives/archive-detail/article-preview/the-evaulation-of-risk-scorings-in-non-variceal-up/47540
|
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