AI Summary & Key Takeaways
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Abstract
Background/aims: This study aimed to allow decision-making about hospitalization or discharge using the Glasgow Blatchford Scoring system, a risk analysis performed using basic laboratory and clinical variables, in patients presenting to the Emergency Department with upper gastrointestinal system bleeding. Materials and Methods: This prospective, observational study conducted in the Emergency Department of a university hospital enrolled patients aged ≥18 years, who presented to the Emergency Department with upper gastrointestinal system bleeding between June 2009 and December 2010. For all patients, Glasgow Blatchford Scoring scores were calculated, and the patients were classified into two groups as high-risk and low-risk patients. Results: A total of 160 subjects with upper gastrointestinal system bleeding were enrolled in the study. Mean Glasgow Blatchford Scoring scores were 7.1±3.8 for 71 low-risk subjects and 11.7±2.9 for 89 high-risk subjects, and the difference between the two groups was statistically significant (p<0.001). When the performance of the Glasgow Blatchford Scoring system was evaluated in the determination of high risk, the sensitivity and specificity were 100% and 1.41%, respectively, for a cut-off value of Glasgow Blatchford Scoring >0, 100% and 16.9% for a cut-off value of Glasgow Blatchford Scoring >3, 96.63% and 36.62% for a cut-off value of Glasgow Blatchford Scoring >5, and 86.52% and 69.01% for a cut-off value of Glasgow Blatchford Scoring >8. In the receiver operating characteristic curve analysis, for Glasgow Blatchford Scoring in the high-risk estimation, the area under the curve was found to be 0.82 (95% CI: 0.75-0.88), and this value was statistically significant (p=0.0001). Conclusions: The Glasgow Blatchford Scoring system, which may be easily calculated based on laboratory and clinical variables, seems to be a useful scoring system for risk analysis of all patients with upper gastrointestinal system bleeding admitted to the Emergency Department. Top Summary Introduction Materials And Methods Results Discussion References
Özet
Amaç: Bu calığmanın amacı Acil Servise ust gastrointestinal sistem kanaması ile bağvuran hastalarda, temel laboratuar ve klinik de.iğkenler kullanılarak yapılan bir risk analizi olan Glasgow Blatchford Skorlama sistemi kullanılarak; yatığ ya da taburculuk kararının verilebilmesidir. Gereç ve Yöntem: Bir Universite hastanesi Acil Servisinde yurutulen bu prospektif gozlemsel calığmada, Haziran 2009- Aralık 2010 tarihleri arasında ust gastrointestinal sistem kanaması ile Acil Servise bağvuran 18 yağ ustu olgular calığmaya alındı. Tum olguların Glasgow Blatchford Skorlama de.erleri hesaplandı. Ayrıca hastalar yuksek riskli ve duğuk riskli olarak iki gruba ayrıldı. Bulgular: Calığmaya ust gastrointestinal sistem kanamalı toplam 160 olgu alındı. Duğuk riskli 71 olgunun ortalama Glasgow Blatchford Skorlama de.eri 7.1 }3.8 iken, yuksek riskli 89 olgunun ortalama Glasgow Blatchford Skorlama de.eri 11.7 }2.9 idi ve her iki grup arası nda istatistiksel olarak anlamlı fark vardı (p 0 icin sensitivitesi %100 ve spesifitesi %1.41, Glasgow Blatchford Skorlama> 3 icin sensitivitesi %100 ve spesifitesi %16.9, Glasgow Blatchford Skorlama>5 icin sensitivitesi %96.63 ve spesifitesi %36.62 ve Glasgow Blatchford Skorlama>8 icin sensitivitesi %86.52 ve spesifitesi %69.01 olarak saptandı. ROC e.risi analiziyle, yuksek riski tahmininde Glasgow Blatchford Skorlama icin area under curve 0,82 (%95 CI 0,75-0,88) saptandı ve istatistiksel olarak anlamlı idi (p=0.0001). Sonuç: Laboratuvar ve klinik de.iğkenlere bakılarak kolaylıkla hesaplanabilen Glasgow Blatchford Skorlama sistemi Acil Servise bağvuran tum ust gastrointestinal sistem kanamalı hastaların risk analizinde kullanığlı bir skorlama gibi gorunmektedir.