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.
Rupture of Hydatid Liver Cyst into Peritoneal Cavity Following Blunt Abdominal Trauma; a Case Report
Hydatid cyst is a serious parasitic infection in places, which people has a close contact with dogs or sheep. They may be found as an incidental findings during routine clinical examination or even followed by radiograph...
Regression to Middle Effect May Threaten Validity of Triage Scales; a Letter to Editor
Triage is sorting patients based on acuity in order to manage care in the emergency department (ED) (1). Medical institutes are trying to develop triage scales compatible with their own culture of care. A triage scale mu...
An 88-Year-Old Man with Sudden Onset Abdominal Pain
An 88-year-old man presented to the emergency de-partment with sudden onset of abdominal pain since 6 hours before. He described his pain as an epigastric pain that had become generalized without any radia-tion. The pain...
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...
Quality of Cardiopulmonary Resuscitation in Emergency Department Based on the AHA 2015 Guidelines; a Brief Report
Abstract: Glasgow Coma Scale and FOUR Score in Predicting the Mortality of Trauma Patients; a Diagnostic Accuracy Study Introduction: Adhering to existing guidelines on cardiopulmonary resuscitation (CPR) can increase th...