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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 28, 2008; 14(32): 5046-5050
Published online Aug 28, 2008. doi: 10.3748/wjg.14.5046
Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy
Leonardo Tammaro, Maria Carla Di Paolo, Angelo Zullo, Cesare Hassan, Sergio Morini, Sebastiano Caliendo, Lorella Pallotta
Leonardo Tammaro, Maria Carla Di Paolo, Sebastiano Caliendo, Lorella Pallotta, Gastroenterology and Digestive Endoscopy II, “San Giovanni Addolorata” Hospital, Rome 00184, Italy
Angelo Zullo, Cesare Hassan, Sergio Morini, Gastroentero-logy and Digestive Endoscopy, “Nuovo Regina Margherita” Hospital, Rome 00153, Italy
Author contributions: Tammaro L and Di Paolo MC designed the research; Tammaro L, Di Paolo MC, Caliendo S and Pallotta L performed research; Zullo A and Hassan C analyzed data and wrote the paper; Morini S contributed with constructive criticisms.
Correspondence to: Dr. Angelo Zullo, Gastroenterologia ed Endoscopia Digestiva, Ospedale Nuovo Regina Margherita, Via E. Morosini, 300, Roma 00153, Italy. zullo66@yahoo.it
Telephone: +39-06-58446533 Fax: +39-06-58446608
Received: May 28, 2008
Revised: July 28, 2008
Accepted: August 4, 2008
Published online: August 28, 2008
Abstract

AIM: To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy.

METHODS: All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis.

RESULTS: Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haemorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; χ2 = 304.5309, P < 0.001). Older age (t = 3.311; P < 0.01) and presence of comorbidities (χ2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients.

CONCLUSION: Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further, randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.

Keywords: Upper gastrointestinal bleeding; Urgent endoscopy; Timing score; Endoscopic treatment; Oesophageal varices; Peptic ulcer