title: Prospective validation of the Baylor bleeding score for predicting the likelihood of rebleeding after endoscopic hemostasis of peptic ulcers.
abstract: Endoscopic therapy is effective in securing hemostasis for bleeding ulcers, but bleeding recurs in 10% to 30% of patients. Prospective identification of patients at increased risk for rebleeding is requisite to reducing rebleeding rates. We previously developed a three-component scoring system that identifies patients at increased risk for rebleeding. In the present study, we prospectively validated our scoring system. Forty-seven men ranging in age from 23 to 95 years in whom endoscopic therapy for bleeding ulcers was successful were studied. Patients with pre-endoscopy scores greater than 5 or postendoscopy scores greater than 10 were stratified as high-risk, and patients with pre-endoscopy scores of 5 or less and post-endoscopy scores of 10 or less as low-risk. Twenty-six patients were categorized as high-risk and 19 as low-risk. All patients were followed until discharged from the hospital. The rebleeding rate for high-risk patients was 31% (8 of 26), compared with 0 for low-risk patients (p < .05). We conclude that our scoring system accurately predicts patients at increased risk for rebleeding after successful endoscopic therapy of bleeding ulcers.
authors.affiliation: Department of Medicine, Veterans Affairs Medical Center, Houston, Texas, USA.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Saeed
authors.forename: F C
authors.initials: FC
authors.lastname: Ramirez
authors.forename: K S
authors.initials: KS
authors.lastname: Hepps
authors.forename: R A
authors.initials: RA
authors.lastname: Cole
authors.forename: D Y
authors.initials: DY
authors.lastname: Graham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004381:Duodenal Ulcer / Q000150:complications*; D005500:Follow-Up Studies; D016558:Hemostasis, Endoscopic / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013276:Stomach Ulcer / Q000150:complications*