Retrospective Analyses of the Utility of Glasgow-Blatchford and Rockall and Pre-Rockall Scoring Systems in Patients Admitted to the Emergency Department with Upper Gastrointestinal System Bleeding

Abstract

Objective: Risk scoring is the key point of the upper gastrointestinal bleeding (GIB) which determines the management of the patient. In this study our aim is to measure the success of Rockall score (RS) and Blatchford score that are frequently used in upper GIB. Methods: In this retrospective descriptive type of study, the patients over 18 years of age who referred to emergency department with upper GIB between the years 2010-2012 were included. A total of 423 patients were included in study. Pre-endoscopic Rockall (PRS), complete RS and Blatchford scores are calculated. High-risk patient, transfusion and mortality predictions of these three scoring and shock index (SI) were calculated statistically. Results: Of the 423 patients 293 (69.3%) were males and mean age was 63.7+-15.7 years. The frequency of melena was 78% (n=330), hematemesis 49.6% (n=210), and syncope 12.1% (n=51) in the patients' complaints at admission. Mean PRS was 3.15+-1.61, RS was 5.05+-2.13, Blatchford score was 10.19+-3.78, and SI was 0.82+-0.25. Blatchford score was found to be the most successful in predicting transfusion. RS and Blatchford score were the most successful scores in predicting the high-risk patient. In our study, the mortality rate was 5.7% (n=24), and the RS was the most valuable score in estimation. Conclusion: By identifying low and high risk patients for transfusion, need for hospitalization, and mortality, risk scores can be used safely by the clinician to guide the treatment of patients.

Keywords

• upper gastrointestinal bleeding
• shock index
• rockall score
• blatchford score