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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Feb 15, 2016; 7(1): 86-96
Published online Feb 15, 2016. doi: 10.4291/wjgp.v7.i1.86
Upper gastrointestinal bleeding risk scores: Who, when and why?
Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter
Sara Monteiro, Tiago Cúrdia Gonçalves, Joana Magalhães, José Cotter, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Creixomil, 4835-044 Guimarães, Portugal
José Cotter, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, ICVS/3B’s Associate Laboratory, University of Minho, Campus de Gualtar, 4835-044 Braga/Guimarães, Portugal
Author contributions: Monteiro S performed the literature search; Monteiro S, Gonçalves TC and Magalhães J wrote the paper; Cotter J designed and conducted the manuscript, critically revised the paper and finally approved the version to be submitted. All authors read and approved the final paper.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sara Monteiro, MD, Department of Gastroenterology, Hospital Senhora da Oliveira-Guimarães, Rua dos Cutileiros, Creixomil, 4835-044 Guimarães, Portugal. sara.s.o.monteiro@gmail.com
Telephone: +351-25-3540330 Fax: +351-25-3513592
Received: June 26, 2015
Peer-review started: June 26, 2015
First decision: August 3, 2015
Revised: October 14, 2015
Accepted: December 9, 2015
Article in press: December 11, 2015
Published online: February 15, 2016
Processing time: 219 Days and 17.1 Hours
Abstract

Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of the complications, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. The use of risk scoring systems in early assessment of patients suffering from UGIB may be useful to distinguish high-risks patients, who may need clinical intervention and hospitalization, from low risk patients with a lower chance of developing complications, in which management as outpatients can be considered. Although several scores have been published and validated for predicting different outcomes, the most frequently cited ones are the Rockall score and the Glasgow Blatchford score (GBS). While Rockall score, which incorporates clinical and endoscopic variables, has been validated to predict mortality, the GBS, which is based on clinical and laboratorial parameters, has been studied to predict the need of clinical intervention. Despite the advantages previously reported, their use in clinical decisions is still limited. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact.

Keywords: Upper gastrointestinal bleeding; Risk scores; Risk assessment; Rockall score; Glasgow blatchford score

Core tip: Upper gastrointestinal bleeding (UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of complications, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact.