Full and Modified Glasgow-Blatchford Bleeding Score in Predicting the Outcome of Patients with Acute Upper Gastrointestinal Bleeding; a Diagnostic Accuracy Study
Journal Title: Archives of Academic Emergency Medicine - Year 2018, Vol 6, Issue 1
Abstract
Introduction: Screening of high risk patients and accelerating their treatment measures can reduce the burden of the disease caused by acute upper gastrointestinal (GI) bleeding. This study aimed to compare the full and modified Glasgow-Blatchford Bleeding Score (GBS and mGBS) in prediction of in-hospital outcomes of upper GI bleeding. Methods: In the present retrospective cross-sectional study, the accuracy of GBS and mGBS models were compared in predicting the outcome of patients over 18 years of age with acute upper GI bleeding confirmed via endoscopy, presenting to the emergency departments of 3 teaching hospitals during 4 years. Results: 330 cases with the mean age of 59.07 ± 19.00 years entered the study (63.60% male). Area under the curve of GBS and mGBS scoring systems were 0.691 and 0.703, respectively, in prediction of re-bleeding (p = 0.219), 0.562 and 0.563 regarding need for surgery (p = 0.978), 0.549 and 0.542 for endoscopic intervention (p = 0.505), and 0.767 and 0.770 regarding blood transfusion (p = 0.753). Area under the ROC curve of GBS scoring system regarding need for hospitalization in intensive care unit (0.589 vs. 0.563; p = 0.035) and mortality (0.597 vs. 0.564; p = 0.011) was better but the superiority was not clinically significant. Conclusion: GBS and mGBS scoring systems have similar accuracy in prediction of the probability of re-bleeding, need for blood transfusion, surgery and endoscopic intervention, hospitalization in intensive care unit, and mortality of patients with acute upper GI bleeding.
The Risk of Venous Thromboembolism Associated with Oral Contraceptive; the Search Is Still On
A few years after coming to the market, the first generation of oral contraceptive pills (OCPs) were linked to signifi-cant risk of venous thromboembolism (VTE). This in-creased risk was blamed on the presence of the est...
True Vertigo Patients in Emergency Department; an Epidemiologic Study
Introduction: Vertigo prevalence is estimated to be 1.8% among young adults and more than 30% in the elderly. 13-38% of the referrals of patients over 65 years old in America are due to vertigo. Vertigo does not increase...
Early Intubation vs. Supportive Care in Management of Severe Blunt Chest Trauma; a Randomized Trial Study
Introduction: Early intubation is one of the critical issues in patients with chest trauma. This study aimed to examine the effect of early intubation on outcomes of patients with severe blunt chest trauma. Methods: Thi...
Brief Emergency Department Patient Satisfaction Scale (BEPSS); Development of a New Practical Instrument
Introduction: Methodologically correct assessment of patient satisfaction (PS) plays a crucial role for quality-improvement purposes. Evaluation of Iranian literature on emergency department’s PS resulted in an emerging...
Proper Angle of Sono-guided Central Venous Line Insertion; a Brief Report
Introduction: Determining the proper angle for inserting central venous catheter (CV line) is of great importance for decreasing the complications and increasing success rate. The present study was designed to determine...