A Giese1, C Grunwald2, J Zieren3, N J Büchner4, B F Henning2. 1. Department of Internal Medicine I, St Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany; Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany. arnd.giese@rub.de. 2. Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany. 3. Department of Surgery, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany. 4. Department of Internal Medicine I, Pulmonology Unit, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany.
Abstract
OBJECTIVES: To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission. METHODS: The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For 'high risk' situations (Forrest stage Ia-IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay ≥ 3 days). RESULTS: During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients' age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score ≥ 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found. CONCLUSION: In patients with UGI-B subject to after-hours endoscopy, a 'high-risk' Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A 'high-risk' Forrest score is not significantly associated with the study endpoints.
OBJECTIVES: To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission. METHODS: The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For 'high risk' situations (Forrest stage Ia-IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay ≥ 3 days). RESULTS: During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients' age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score ≥ 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found. CONCLUSION: In patients with UGI-B subject to after-hours endoscopy, a 'high-risk' Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A 'high-risk' Forrest score is not significantly associated with the study endpoints.
Authors: L Camellini; A Merighi; C Pagnini; F Azzolini; S Guazzetti; A Scarcelli; F Manenti; G P Rigo Journal: Dig Liver Dis Date: 2004-04 Impact factor: 4.088
Authors: Adam B Adamopoulos; Nikolaos M Baibas; Stamatis P Efstathiou; Dimitrios I Tsioulos; Athanasios G Mitromaras; Amalia A Tsami; Theodore D Mountokalakis Journal: Eur J Gastroenterol Hepatol Date: 2003-04 Impact factor: 2.566