The predictive capacity of the Glasgow-Blatchford score for the risk stratification of upper gastrointestinal bleeding in an emergency department.

OBJECTIVES: To assess the ability of the Glasgow Blatchford Score (GBS) system to identify the need for urgent upper gastrointestinal endoscopy (UGIE) in patients with upper gastrointestinal bleeding (UGIB). METHODS: An observational, retrospective study was carried out in all patients attended at the ER for suspected UGIB in one year. Patients were split into two categories -high-risk (>2) and low-risk ( < or = 2)- by means of the GBS system. RESULTS: A total of 60 patients were included. Of these, 46 were classified as "high-risk" (> 2) and 14 as "low-risk" ( < or = 2) subjects.The characteristics of patients in the low-risk group included: Mean age: 46.6 +/- 13.7 (18-88) years. Males/females: 7/7. Urgent endoscopy revealed: normal (50%; n = 7); esophagitis (21.4%; n = 3); gastritis (14.2%; n = 2); Mallory-Weiss syndrome (7.1%; n = 1); non-bleeding varices (7.1%; n = 1). The characteristics of patients in the high-risk group included: Mean age: 68.7 +/- 19.8 (31-91) years. Males/females: 30/16. Digestive endoscopy revealed: Gastric/duodenal ulcer (56.52%; n = 26); normal (17.39%; n = 8); esophagitis (8.69%; n = 4); gastritis (8.69%; n = 4); angioectasia (4.34%; n = 2); bleeding varices (4.34%; n = 2). Low-risk patients exhibited no lesions requiring urgent management during endoscopy, and the sensitivity of the GBS scale for high-risk UGIB detection was found to be 100% (95% CI: 86.27%, 99.71%), with a specificity of 48.28% (95% CI: 29.89, 67.1%). CONCLUSIONS: The GBS scale seems to accurately identify patients with low-risk UGIB, who may be managed on an outpatient basis and undergo delayed upper GI endoscopy at the outpatient clinic.

Capacidad predictiva de la escala de Glasgow-Blatchford para la estratificación del riesgo de la hemorragia digestiva alta en un servicio de urgencias / The predictive capacity of the Glasgow-Blatchford score for the risk stratification of upper gastrointestinal bleeding in an emergency department

OBJETIVOS: evaluar la capacidad del sistema de puntuación Glasgow Blatchford (GBS) para identificar la necesidad de realizar una endoscopia digestiva alta urgente (EDA) en pacientes con hemorragia digestiva alta (HDA). MÉTODOS: se realizó un estudio observacional retrospectivo de todos los pacientes que acudieron a Urgencias con sospecha de HDA durante un año. Los pacientes se dividieron en dos categorías, de alto (> 2) y de bajo riesgo (≤2), utilizando la puntuación GBS. RESULTADOS: un total de 60 pacientes fueron incluidos. De estos, 46 fueron clasificados como de "alto riesgo" (> 2) y 14 de "bajo riesgo" (≤2). Las características de los pacientes del grupo de bajo riesgo fueron: edad media: 46,6 ± 13,7 (18-88) años. Varones/mujeres: 7/7. La endoscopia urgente mostró: EDA normal (50%; n = 7); esofagitis (21,4%; n = 3); gastritis (14,2%; n = 2); síndrome Mallory-Weiss (7,1%; n = 1) y varices sin sangrado (7,1%; n = 1). Las características de los pacientes del grupo de alto riesgo fueron: edad media: 68,7 ± 19,8 (31-91) años. Varones/mujeres: 30/16. La endoscopia digestiva alta mostró: úlcera gástrica/duodenal (56,52%; n = 26); EDA normal (17,39%; n = 8); esofagitis (8,69%; n = 4); gastritis (8,69%; n = 4); angioectasia (4,34%; n = 2) y varices con sangrado (4,34%; n = 2). Los pacientes con bajo riesgo no presentaron en la endoscopia urgente lesiones que precisaran de tratamiento durante la misma, objetivándose una sensibilidad de la escala GBS para detectar HDA de alto riesgo del 100% (IC 95%: 86,27%, 99,71%) y una especificidad del 48,28% (IC 95%: 29,89, 67,1%). CONCLUSIONES: la escala GBS parece identificar con precisión los pacientes con HDA de bajo riesgo, que pueden ser manejados de forma ambulatoria, realizándose la endoscopia digestiva alta de forma diferida en consultas externas

OBJECTIVES: To assess the ability of the Glasgow Blatchford Score (GBS) system to identify the need for urgent upper gastrointestinal endoscopy (UGIE) in patients with upper gastrointestinal bleeding (UGIB). METHODS: An observational, retrospective study was carried out in all patients attended at the ER for suspected UGIB in one year. Patients were split into two categories -high-risk (>2) and low-risk (≤2)- by means of the GBS system. RESULTS: A total of 60 patients were included. Of these, 46 were classified as "high-risk" (> 2) and 14 as "low-risk" (≤ 2) subjects. The characteristics of patients in the low-risk group included: Mean age: 46.6 ± 13.7 (18-88) years. Males/females: 7/7. Urgent endoscopy revealed: normal (50%; n = 7); esophagitis (21.4%; n = 3); gastritis (14.2%; n = 2); Mallory-Weiss syndrome (7.1%; n = 1); non-bleeding varices (7.1%; n = 1). The characteristics of patients in the high-risk group included: Mean age: 68.7 ± 19.8 (31-91) years. Males/females: 30/16. Digestive endoscopy revealed: Gastric/duodenal ulcer (56.52%; n = 26); normal (17.39%; n = 8); esophagitis (8.69%; n = 4); gastritis (8.69%; n = 4); angioectasia (4.34%; n = 2); bleeding varices (4.34%; n = 2). Low-risk patients exhibited no lesions requiring urgent management during endoscopy, and the sensitivity of the GBS scale for high-risk UGIB detection was found to be 100% (95% CI: 86.27%, 99.71%), with a specificity of 48.28% (95% CI: 29.89, 67.1%). CONCLUSIONS: The GBS scale seems to accurately identify patients with low-risk UGIB, who may be managed on an outpatient basis and undergo delayed upper GI endoscopy at the outpatient clinic