Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy.
OBJECTIVE
To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy.


METHODS
All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis.


RESULTS
Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haemorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; c2 = 304.5309, P < 0.001). Older age (t = 3.311; P < 0.01) and presence of comorbidities (c2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients.


CONCLUSIONS
Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further, randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.
Tammaro
Leonardo
L
Gastroenterologia ed Endoscopia Digestiva, Ospedale Nuovo Regina Margherita, Via E. Morosini 300, Rome, Italy.
Di Paolo
Maria-Carla
MC
Zullo
Angelo
A
Hassan
Cesare
C
Morini
Sergio
S
Caliendo
Sebastiano
S
Pallotta
Lorella
L