The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed
Sergiu Marian Cazacu,
Dragoș Ovidiu Alexandru,
Răzvan-Cristian Statie,
Sevastița Iordache,
Bogdan Silviu Ungureanu,
Vlad Florin Iovănescu,
Petrică Popa,
Victor Mihai Sacerdoțianu,
Carmen Daniela Neagoe,
Mirela Marinela Florescu
Affiliations
Sergiu Marian Cazacu
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Dragoș Ovidiu Alexandru
Biostatistics Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Răzvan-Cristian Statie
Clinical Emergency County Hospital Craiova, 200642 Craiova, Dolj County, Romania
Sevastița Iordache
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Bogdan Silviu Ungureanu
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Vlad Florin Iovănescu
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Petrică Popa
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Victor Mihai Sacerdoțianu
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Carmen Daniela Neagoe
Research Center of Gastroenterology and Hepatology, Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
Mirela Marinela Florescu
Pathology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Dolj County, Romania
(1) Background: The assessment of mortality and rebleeding rate in upper gastrointestinal bleeding (UGIB) is essential, and several prognostic scores have been proposed. Some patients with UGIB did not undergo endoscopy, either because they refused the procedure, suffered from alcohol withdrawal symptoms or altered general status, or because the bleeding was severe enough to cause death before the endoscopy. The mortality risk in the subgroup of patients without endoscopy is poorly evaluated in the literature. (2) Methods: The purpose of the study was to identify the most useful scores for the assessment of in-hospital mortality in patients with UGIB with no endoscopy performed and no known etiology. A total of 198 patients with UGIB and no endoscopy performed were admitted between January 2017 and December 2021 and the accuracy of 12 prognostic scores and the Charlson comorbidity index for in-hospital mortality prediction were analyzed, as well as Child–Pugh Turcotte (CPT) and Meld scores in patients with cirrhosis. (3) Results: The mortality rate was 37.9%, higher than in variceal (21.9%, p p p = 0.0586), mainly because of positive cases. Only one case of rebleeding was noted; the hospitalization period was significantly shorter. The most accurate score was International Bleeding Score; the MELD score had a higher but moderate accuracy compared with CPT in patients with cirrhosis.
