ABSTRACT
Objective To evaluate the guidance value of capsule endoscopy and clinical scoring system in risk stratification for acute upper gastrointestinal bleeding (AUGIB) .Methods 24 patients presenting to the emergency room with AUGIB ,were randomly divided into two groups (12 cases in each group) .Pre‐Endoscopic Blatchford and Rockall scores were calculated for all pa‐tients .All patients underwent endoscopy(EGD) within 24 hours .The timing of EGD was based on clinical scores in control group , and on VCE in observation group .Positive VCE was defined as red blood ,clot or coffee grounds .Mean Rockall and Blatchford scores for all 24 patients were compared to differentiate high‐and low‐risk patients .Rockall and Blatchford scores were also com‐pared with VCE findings .Results A total of 13 out of 24 patients had high‐risk stigmata on EGD ,with the mean Rockall and Blatchford scores of 3 and 13 respectively .Meanwhile ,the mean Rockall and Blatchford scores of the other 11 patients were 2 and 11 .There was no statistically significant difference between the Blatchford scores of the two groups(95% CI:5 .2‐1 .4 ;P=0 .23) . Also there was no statistically significant difference between the Rockall scores of the two groups(95% CI:2 .2‐0 .3;P=0 .12) .In the subgroup of 12 patients who underwent VCE ,9/12 had positive findings confirmed at EGD afterward ,compared with the other 3 patients with negative VCE and endoscopy .Conclusion Both the Rockall and the Blatchford scores are not accurate to predict the degree of risk in patients with AUGIB identified at EGD .However ,VCE is sensitive and specific enough to a better risk stratifica‐tion tool .