title: Upper gastrointestinal bleeding risk scores: Who, when and why?
abstract: Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of the complications, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. The use of risk scoring systems in early assessment of patients suffering from UGIB may be useful to distinguish high-risks patients, who may need clinical intervention and hospitalization, from low risk patients with a lower chance of developing complications, in which management as outpatients can be considered. Although several scores have been published and validated for predicting different outcomes, the most frequently cited ones are the Rockall score and the Glasgow Blatchford score (GBS). While Rockall score, which incorporates clinical and endoscopic variables, has been validated to predict mortality, the GBS, which is based on clinical and laboratorial parameters, has been studied to predict the need of clinical intervention. Despite the advantages previously reported, their use in clinical decisions is still limited. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact.
authors.affiliation: Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Creixomil, 4835-044 Guimarães, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Monteiro
authors.affiliation: Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Creixomil, 4835-044 Guimarães, Portugal.
authors.forename: Tiago Cúrdia
authors.initials: TC
authors.lastname: Gonçalves
authors.affiliation: Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Creixomil, 4835-044 Guimarães, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Magalhães
authors.affiliation: Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Creixomil, 4835-044 Guimarães, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Cotter
keywords: Glasgow blatchford score; Risk assessment; Risk scores; Rockall score; Upper gastrointestinal bleeding