Editorial
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World J Gastroenterol. Jun 14, 2012; 18(22): 2739-2744
Published online Jun 14, 2012. doi: 10.3748/wjg.v18.i22.2739
Update on risk scoring systems for patients with upper gastrointestinal haemorrhage
Adrian J Stanley
Adrian J Stanley, Gastrointestinal Unit, Glasgow Royal Infirmary, Glasgow G4 OSF, United Kingdom
Author contributions: Stanley AJ was the sole contributor to this article.
Correspondence to: Dr. Adrian J Stanley, MD, FRCP (Ed), FRCP (Glasg), Consultant Gastroenterologist, Gastrointestinal Unit, Glasgow Royal Infirmary, Castle Street, Glasgow G4 OSF, United Kingdom. adrian.stanley@ggc.scot.nhs.uk
Telephone: +44-141-2114073 Fax: +44-141-2115131
Received: October 20, 2011
Revised: February 20, 2012
Accepted: April 21, 2012
Published online: June 14, 2012
Abstract

Upper gastrointestinal haemorrhage (UGIH) remains a common medical emergency worldwide. It is increasingly recognised that early risk assessment is an important part of management, which helps direct appropriate patient care and the timing of endoscopy. Several risk scores have been developed, most of which include endoscopic findings, although a minority do not. These scores were developed to identify various end-points including mortality, rebleeding or clinical intervention in the form of transfusion, endoscopic therapy or surgery. Recent studies have reported accurate identification of a very low risk group on presentation, using scores which require simple clinical or laboratory parameters only. This group may not require admission, but could be managed with early out-patient endoscopy. This article aims to describe the existing pre- and post-endoscopy risk scores for UGIH and assess the published data comparing them in the prediction of outcome. Recent data assessing their use in clinical practice, in particular the early identification of low-risk patients, are also discussed.

Keywords: Upper gastrointestinal haemorrhage; Bleeding; Endoscopy; Risk assessment; Scoring systems; Blatchford; Rockall