ABSTRACT
Objective: This study aimed to compare the performances of the Glasgow-Blatchford Bleeding Score [GBS], pre-endoscopic Rockall score [PRS], complete Rockall score [CRS], and Cedars-Sinai Medical Center Predictive Index [CSMCPI] in predicting clinical outcomes in patients with upper gastrointestinal bleeding [UGIB]
Methods: Patients who were admitted to the emergency department because of UGIB and underwent endoscopy within the first 24 hour were included in this study. The GBS, PRS, CRS, and CSMCPI were propectively calculated. The performances of these scores were assessed using a receiver operating characteristic curve
Results: A total of 153 patients were included in this study. For the prediction of high-risk patients, area under the curve [AUC] was obtained for GBS [0.912], PRS [0.968], CRS [0.991], and CSMCPI [0.918]. For the prediction of rebleeding, AUC was obtained for GBS [0.656], PRS [0.625], CRS [0.701], and CSMCPI [0.612]. For the prediction of 30-day mortality, AUC was obtained for GBS [0.658], PRS [0.757], CRS [0.823], and CSMCPI [0.745]
Conclusion: These results suggest that effectiveness of CRS is higher than that of other scores in predicting high-risk patients, rebleeding and 30-day mortality in patients with UGIB
ABSTRACT
To assess the possible use of hyaluronic acid [HA] and interleukin-6 [IL-6] together as a biochemical marker of liver damage in mushroom poisoning [MP]. We prospectively studied patients with MP who were admitted to the emergency service, between April 2005 and April 2007, Samsun, Turkey. Twenty-seven patients with MP were included in the study. Serum HA and IL-6 levels of the patients were determined using enzyme-linked immunosorbent assay daily for a total of 3 days. Ten healthy adults were included in the study to serve as controls. The patients were divided into survivors, and non-survivors. There was no significant difference between the patients and controls with respect to serum HA levels on admission [p > 0.05]. However, IL-6 levels on admission were significantly higher in the patients than the control group [p < 0.01]. Serum HA and IL-6 levels on admission, and the following days were significantly higher in non-surviving patients [n = 5] than in surviving patients [n = 22] [p < 0.05]. There was a significant correlation between HA and IL-6 [r = 0.42, p < 0.05] on admission. The HA concentration was also significantly correlated with aspartate aminotransferase, alanine aminotransferase, and creatinine levels during the observation period. Serum HA and IL-6 levels increased in non-surviving patients throughout the period of observation. Increased serum HA and IL-6 levels are associated with hepatic damage in acute MP. Hyaluronic acid may be a useful marker in the assessment of MP-induced acute liver failure in clinical practice