Patient selection: upper gastrointestinal bleeding
Classification of upper GI bleeding:
(1) severe: required surgery to control bleeding, Grade 3 or 4 shock, died
(2) moderate: controlled bleeding during endoscopy, rebleeding, Grade 1 or 2 shock
(3) mild: no signs of shock, no need for transfusion, endoscopy without need for hemostasis
Parameters:
(1) age in years
(2) pulse in beats per minute
(3) systolic blood pressure in mm Hg
(4) hemoglobin in g/dL
(5) BUN in mg/dL
(6) cirrhosis
(7) hepatic failure
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 60 years
|
0
|
|
|
>= 60 years
|
1
|
|
pulse
|
< 100 beats per minute
|
0
|
|
|
>= 100 beats per minute
|
1
|
|
systolic blood pressure
|
< 100 mm Hg
|
10.5
|
|
|
>= 100 mm Hg
|
0
|
|
hemoglobin
|
< 10 g/dL
|
6
|
|
|
>= 10 g/dL
|
0
|
|
BUN
|
< 35 mg/dL
|
0
|
|
|
>= 35 mg/dL
|
2
|
|
cirrhosis
|
absent
|
0
|
|
|
present
|
2
|
|
hepatic failure
|
absent
|
0
|
|
|
present
|
4.5
|
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 27
• The higher the score the more severe the bleeding.
|
Severity of Bleeding
|
Mean Score
|
Range
|
|
mild
|
3.3
|
0 to 7.4
|
|
moderate
|
9.0
|
4.8 to 13.2
|
|
severe
|
17.7
|
12.7 to 27
|
This information could be used as:
|
Severity of Bleeding
|
Score
|
|
mild
|
0 to 4.7
|
|
mild to moderate
|
4.8 to 7.4
|
|
moderate
|
7.5 to 12.6
|
|
moderate to severe
|
12.7 to 13.2
|
|
severe
|
13.3 to 27
|
