Dong et al reported a score for evaluating a patient with acute nonvariceal upper gastrointestinal (GI) bleeding associated with high-risk stigmata. The authors are from Tongji University in Shanghai.
Patient selection: acute nonvariceal upper GI bleeding
High-risk stigmata:
(1) with peptic ulcer: (bleeding that is spurting, gushing or oozing) OR (nonbleeding visible vessel)
(2) other disease: (bleeding that is spurting or gushing) OR (nonbleeding visible vessel)
Parameters:
(1) hemoglobin in g/L
(2) serum creatinine in µmol/L
(3) serum urea in mmol/L
(4) systolic blood pressure in mm Hg
(5) therapy (mechanical, thermal)
Parameter
Finding
Points
hemoglobin
>= 85 g/L
0
< 85 g/L
1
serum creatinine
<= 100 µmol/L
0
> 100 µmol/L
1
serum urea
<= 9.5 mmol/L
0
> 9.5 mmol/L
1
systolic blood pressure
>= 90 mm Hg
0
< 90 mm Hg
1
therapy
monotherapy
1
greater than monotherapy
0
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 2 is associated with rebleeding (sensitivity 0.95; specificity 0.43).
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