Sourianarayanane, A.; Shenay, A.H.; Foster, D.N.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA81
Academic Journal
There are various scoring systems For upper Gl bleeding to predict mortality, including the Rockall score. The newer Blatchford score predicts the need for intervention. These scores help in management of patients with least intervention requirement who are otherwise investigated including endoscopies after hospitalisation, has not been studied in district general hospital setting where most of the patients are managed. Aims: To validate the Blatchford scoring system in a different population group and also compare it with the Rockall scoring system n identifying the population at least risk of requiring intervention. Methods: All patients presenting to the hospital with the diagnosis of upper Gl bleeding during a 12 month period were included in this study. They were scored using Blatchford and Rockall systems and the results compared with the outcome. Results: Of 17 249 general medical patients admitted, 225 had upper Gl bleeding. As in other studies there was a close correlation between mortality and the initial Rockall score (eg Score 2 in his study mortality was 5.6%; in this study 12.1%. Score 5 in his 39.6%; in this 30% mortality). Surprisingly a relationship also existed between the Rockall score and the need for intervention and length of stay, not found in previous studies. As in the original study the Blatchford score predicted the need for intervention and length of stay. With a Blatchford score of 0, the need for intervention in this study was 3.8% versus 1.8% in the Blatchford study; a score of 6 was associated with intervention in 62.5% versus 50.4% in the Blatchford study. As suggested in the Blatchford study group of patients with Hb > 13.0 gm/dl in men and > 12.0 gm/dl in women, urea < 6.5mmol/I, systolic BP > 110 mm Hg, and pulse < 100, (15.56% of patients) the need for intervention is Iow at 2.8% and in those < 65 years of age (8.9% of patients) is 0%. Similarly no intervention is needed in patients with value of 0 in both Blatchford and...


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