Ogasawara et al identified findings predictive of intractable bleeding from a peptic ulcer after endoscopic hemostasis. The authors are from Aichi Medical University in Japan.
Patient selection: bleeding gastroduodenal peptic ulcer treated by endoscopy
Outcome: intractable bleeding
Parameters:
(1) age in years
(2) shock on admission
(3) hemoglobin in g/dL
(4) serum albumin in g/dL
(5) exposed vessel with diameter >= 2 mm on the bottom of the ulcer
(6) Forrest type
Parameter
Finding
Points
age in years
< 70 years
0
>= 70 years
1
shock on admission
no
0
yes
1
hemoglobin
>= 8 g/dL
0
< 8 g/dL
1
serum albumin
>= 3.3 g/dL
0
< 3.3 g/dL
1
exposed vessel
no
0
yes
1
Forrest type
II or III
0
IA or IB
1
score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The risk factors are associated with intractable bleeding after endoscopic hemostasis.
• A patient with risk factors may benefit from more aggressive management such as transarterial
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