title: Use of the Complete Rockall Score and the Forrest Classification to Assess Outcome in Patients with Non-variceal Upper Gastrointestinal Bleeding Subject to After-hours Endoscopy: A Retrospective Cohort Study.
abstract: OBJECTIVE
  To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission.
  
  
  METHODS
  The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For 'high risk' situations (Forrest stage Ia-IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay ≥ 3 days).
  
  
  RESULTS
  During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients' age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score ≥ 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found.
  
  
  CONCLUSIONS
  In patients with UGI-B subject to after-hours endoscopy, a 'high-risk' Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A 'high-risk' Forrest score is not significantly associated with the study endpoints.
authors.affiliation: Department of Internal Medicine I, St Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany; Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany. arnd.giese@rub.de.
authors.forename: A
authors.initials: A
authors.lastname: Giese
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Grunwald
authors.affiliation: Department of Surgery, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Zieren
authors.affiliation: Department of Internal Medicine I, Pulmonology Unit, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany.
authors.forename: N J
authors.initials: NJ
authors.lastname: Büchner
authors.affiliation: Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany.
authors.forename: B F
authors.initials: BF
authors.lastname: Henning