Graham et al developed an endoscopic scoring system for grading injury to the gastric mucosa associated with amino-bisphophonate therapy. The authors are from the Veterans Affairs Medical Center and Baylor College of Medicine in Houston.
Parameters:
(1) grade of mucosal hemorrhage
(2) mucosal erosions (discontinuance in mucosa but without depth)
(3) ulceration (lesion >= 5 mm in diameter with depth; the term for a lesion < 5 mm in diameter with depth was not specified)
|
Mucosal Hemorrhages |
Grade |
|
none |
0 |
|
1 discrete area |
1 |
|
2 discrete areas |
2 |
|
3 or more discrete areas ("numerous") but not widespread |
3 |
|
widespread |
4 |
where:
• Grade 2 was defined as more than 1 area of mucosal hemorrhage but neither numerous or widespread. Numerous is defined in Grade 3 as 3 or more foci. Thus Grade 2 is limited to 2 areas of mucosal hemorrhage.
|
Mucosal Hemorrhage |
Other Lesions |
Ulcerations |
Final Grade |
|
none or Grade 1 |
none |
none |
0 |
|
Grade 2 to 4 |
none |
none |
A |
|
NA |
1 or 2 discrete erosions |
none |
B |
|
NA |
3 or more discrete erosions but not extensive |
none |
C |
|
NA |
extensive (widespread involvement) |
NA |
D |
|
NA |
NA |
1 or more ulcerations |
D |
|
Final Grade |
Level of Injury |
|
0 or A |
none or minimal |
|
B |
moderate |
|
C or D |
severe |
Specialty: Gastroenterology, Pharmacology, clinical
ICD-10: ,
