title: [Pre-endoscopic assessment to predict outcome of acute upper gastrointestinal bleeding--a retrospective study in patients subject to emergency endoscopy outside regular working hours].
abstract: OBJECTIVE
  To evaluate the predictive value of pre-endoscopic risk scores in patients with upper gastrointestinal bleeding (UGI-B).
  
  
  METHODS
  The medical records of patients evaluated by emergency esophago-gastro-duodenoscopy (E-EGD) for suspected UGI-B outside regular working hours were retrospectively analysed.
  
  
  RESULTS
  During the 75 months of the study period 112 E-EGDs met the inclusion criteria. Mean age was 65.5 ± 14.7 years. 38.4 % of patients were female. Endoscopy revealed 41 gastro-duodenal ulcers, 16 Mallory-Weiss, 13 varices, 4 neoplasia. 72 patients received transfusions, 39 had endoscopic interventions. 2 patients were surgically treated, 16 had recurrent bleeding. 16 of the 110 patients died during hospitalisation. The following sensitivities were found for the Blatchford score (cut-off > 1), the clinical Rockall score (cut-off > 0) and the Adamopoulos score (cut-off > 2) in predicting need for clinical intervention (endoscopic or surgical intervention or transfusion): 100/97.7/93%, recurrent bleeding: 100/100/93.8%, in-hospital mortality: 100/93.8/93.8%, respectively.
  
  
  CONCLUSIONS
  The Blatchford score is a suitable tool in determining the need for clinical intervention and the risk of recurrent bleeding and death in patients with UGI-B. The clinical Rockall score and the Adamopoulos score (the latter had originally been developed to predict active UGI-B at endoscopy and was used with a lower cut-off in our study) are inferior alternatives.
authors.affiliation: Zentrale Patientenaufnahme, Marienhospital Herne, Klinikum der Ruhr-Universität Bochum. arnd.giese@rub.de
authors.forename: A
authors.initials: A
authors.lastname: Giese
authors.forename: C
authors.initials: C
authors.lastname: Grunwald
authors.forename: J
authors.initials: J
authors.lastname: Zieren
authors.forename: N J
authors.initials: NJ
authors.lastname: Büchner
authors.forename: B F
authors.initials: BF
authors.lastname: Henning
mesh_terms: D039602:After-Hours Care; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D016145:Endoscopy, Digestive System; D017707:Erythrocyte Transfusion; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000145:classification* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D005858:Germany; D006488:Hemostasis, Surgical; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016019:Survival Analysis