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World J Gastroenterol ; 14(32): 5046-50, 2008 Aug 28.
Article in English | MEDLINE | ID: mdl-18763288

ABSTRACT

AIM: To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy. METHODS: All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis. RESULTS: Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haemorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; c2 = 304.5309, P < 0.001). Older age (t = 3.311; P < 0.01) and presence of comorbidities (c2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients. CONCLUSION: Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further, randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.


Subject(s)
Endoscopy, Gastrointestinal , Esophageal and Gastric Varices/epidemiology , Esophageal and Gastric Varices/pathology , Peptic Ulcer Hemorrhage/epidemiology , Peptic Ulcer Hemorrhage/pathology , Aged , Endoscopy, Gastrointestinal/statistics & numerical data , Female , Humans , Incidence , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Risk Factors
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