The Relationship between Pre-endoscopic Rockall Score and Clinical Course of Patients Presenting wit Non-Variceal Upper gastrointestinal Bleeding in the Emergency Department

Year 2019, Volume: 1 Issue: 1, 1 - 7, 01.11.2019

İbrahim Özgür Şahin Selen Acehan Akkan Avci , Müge Gülen , Salim Satar

https://doi.org/10.38175/phnx.621968

Cited By: 1

Abstract

Aim: There
are several scoring systems used for determining the mortality and surgery need
among the patients with gastrointestinal bleeding. Aim of this study is to
evaluate the relationship between the preendoscopic Rockall score (PreRS) and
clinical outcome of the patients with nonvariceal upper gastrointestinal
bleeding admitted to emergency department.

Material and Method: Patients
over 18 years of age who admitted to our emergency department due to the
nonvariceal upper gastrointestinal bleeding between August 2014 and July 2015
were included in this retrospective study.

Results: A
total of 368 patients were included in this study. The mean age of the patients
was 63,03±17,43 years of age. According to the calculated PreRS 56 (15,2%) of
the patients were at low risk group whereas 312 (84,8%) of patients were at
high risk group. The ratio of the patients with endoscopic Forrest IIc and III
ulcers in the high risk PreRS group was significantly lower than the low risk
PreRS group (p<0,05). The ratio of the patients who were accepted to
intensive care unit or died at the emergency department in the high risk PreRS
group was significantly higher than the low risk PreRS group (p<0,05). The
ratio and number of the blood transfusion in the high risk PreRS group was
significantly higher than the low risk PreRS group (p<0,05). The ratios of
the patients with surgery need, rebleeding, mortality during hospitalization
and the length of hospital stay were not significantly different in both low and
high risk PreRS groups (p>0,05).

Conclusion: Despite
various restrictions, PreRS is helpful for risk stratification of the patients
admitted to the emergency department with nonvariceal upper gastrointestinal
bleeding but it is not helpfull in predicting the clinical outcome of these
patients. 

Keywords

Emergency Department, Upper Gastrointestinal Bleeding, Pre-endoscopic Rockall Score

Acil Serviste Non-varisiyel Üst Gastrointestinal Sistem Kanaması ile Başvuran Hastaların Pre-endoskopik Rockall Skorunun Klinik Seyir ile İlişkisi

Abstract

Amaç:
Gastrointestinal sistem kanamalarında mortalite ve cerrahiye gidecek hastaların
belirlenmesinde birçok skorlama sistemi kullanılmaktadır. Bu çalışmanın amacı
acil servise başvuran akut nonvarisiyel üst gastrointestinal sistem kanamalı
hastaların preendoskopik Rockall skoru (PreRS)  ile klinik seyri arasındaki ilişkinin
değerlendirmektir.

Materyal ve Metod:
Ağustos 2014 ve Temmuz 2015 arası acil servisimize başvuran 18 yaş üstü
nonvarisiyel üst gastrointestinal sistem kanaması tanısı alan hastalar
retrospektif olarak çalışmaya dahil edildi.

Bulgular: Bu
çalışmaya toplam 368 hasta dahil edildi. Hastaların ortalama yaşı 63,03±17,43
idi. PreRS’na göre hastaların 56’sı (% 15,2) düşük riskli, 312’si (% 84,8)
yüksek riskli grupta idi. PreRS yüksek riskli olan grupta endoskopik Forrest
IIc ve III olan hasta oranı PreRS düşük riskli olan gruptan anlamlı (p<0,05)
olarak düşük bulundu. Hastaların yoğun bakım yatışı ve acilde exitus oranı
PreRS yüksek riskli olan grupta PreRS düşük risk olan gruptan anlamlı (p<0,05)
olarak daha yüksek bulundu. PreRS yüksek risk olan grupta kan transfüzyon
yapılma oranı ve sayısı PreRS düşük risk olan gruptan anlamlı (p ˂ 0,05) olarak
daha yüksek bulundu. PreRS düşük ve yüksek olan grupta cerrahi geçirme, tekrar
kanama, yatışta exitus oranları ve yatış süresi anlamlı (p ˃ 0,05) farklılık
saptanmadı.

Sonuç: Çeşitli
kısıtlılıkları olmasına karşın acil servise başvuran NVÜGK’lı hastaların risk
sınıflamasının yapılmasında PreRS faydalı olduğu, ancak seyrin öngörülmesinde
yardımcı olmayabileceği söylenebilir.

Keywords

Acil Servis, Gastrointestinal Kanama, Preendoskopik Rockall skoru

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